Superstition Fire & Medical District
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Ride-Along Application

Complete the Ride-Along Application form below.

Please allow up to 10 business days for us to process your application.


    APPLICANT INFORMATION

    Applicant Name

    Email Address*

    Phone Number

    Phone Type

    Home Address

    Street Address

    City

    Zip Code

    Please provide 2-3 dates that you would like to complete your ride-along.

    LIABILITY WAIVER

    The intent of the Superstition Fire & Medical District Ride-Along Program is to provide an opportunity for individuals to accompany SFMD personnel to observe them in the performance of their duties.

    The rider is aware that such duties may create a hazard to the rider and/or to the firefighters.

    The Fire District agrees to permit the rider to "Ride-Along" with Superstition Fire & Medical District personnel on date(s) to be determined.

    The rider agrees to the following:
    • In consideration for the privileges of accompanying a crew, I do hear by hold harmless, release and discharge the District from all claims, present and future, known or unknown, in any manner arising out of my participation in the Ride-Along Program. I specifically waive any and all rights I have or may have in the future under the Arizona and/or Federal Tort Claims Act or any other statute.
    • I agree to comply fully with any directives, orders, or requests from Fire District personnel during the Ride-Along Program.
    • I agree to strictly observe the confidentiality of District and patient records. Any breach of confidentiality will result in the termination of privileges and may result in legal action against me.
    • I have read and understood this release agreement and all of its terms. I have executed it voluntarily and with full knowledge of its significance.
    • I understand that riding along with Superstition Fire & Medical District personnel may expose me to risks such as hazardous material, infectious diseases, traumatic situations, etc.
    • I understand that I must be able to function in such a way as to not impede the functions of the crew as they perform routine or emergency duties.

    AFFIRMATIONS







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    • Child Passenger Safety
      • Car Seat Install Request Form
    • Community Outreach
    • CPR/AED & First Aid
      • CPR Sign-up
    • CPR/AED & First Aid Courses
    • Emergency Preparedness
    • Fire Safety
    • Hands Only CPR Instructions
    • Older Adult Safety
    • Public Access to Defibrillation
    • Ride-Along
      • Ride-Along Application
    • Water Safety
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    I want to...

    Sign up for a CPR or First Aid Class
    Verify emergency services to my property (for homeowner’s insurance)
    Schedule a business or construction inspection
    Schedule a car seat check
    Schedule at station tour or community event
    Submit a records request
    Get information about smoke alarms
    Go on a Ride-Along
    Get a Burn Permit
    Write a note to the Fire Chief
    Contact an SFMD office
    Report a fire hazard or code violation

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