SHAWNEE POLICE DEPARTMENT
Civilian Observer Program Application
Citizens wishing to request to ride along with on-duty police officers must:
 Be 18 years of age or older.
 Be a resident of Shawnee, Kansas.
 Have no prior criminal or serious traffic offense record.
 Have no physical, medical, or mental condition which would negatively affect participation in this program.
 Has not participated in this program in the last six months.
 An exemption will be granted for the residency requirement for non-residents who are enrolled in an accredited
college criminal justice intern program, however all of the other requirements still apply.
Students wishing to request to ride along with on-duty police officers for educational purposes must:
 Be 16 to 17 years of age.
 Parent/guardian must sign the Waiver of Claim and Rules and Guidelines.
 Be a resident or attend school in Shawnee, Kansas.
DATE:
NAME:
LAST NAME
FIRST NAME
RACE:
M.I.
DATE OF BIRTH
MALE
GENDER:
ADDRESS:
CELL PHONE:
CITY:
STATE:
FEMALE
EMAIL ADDRESS:
SCHOOL ATTENDED (IF STUDENT):
REASON FOR RIDE REQUEST:
PREFER TO RIDE:
(DATE)
(DAY)
(TIME)
WAIVER OF CLAIM
I understand as a civilian observer, that I might be exposed to dangers in excess of those normally faced by
passengers in private vehicles. I further certify that I have received a briefing relative to these dangers prior to
placing my signature on this document. I further waive any right or claim against the City of Shawnee, Kansas,
the police department, their officials, officers and employees for loss of life, bodily injury or property damage that
I may sustain as a result of riding as a civilian observer.
PARENT SIGNATURE
CIVILIAN OBSERVER SIGNATURE
PARENT SIGNATURE REQUIRED FOR ALL PERSONS UNDER THE AGE OF 18.
PLEASE COMPLETE OTHER SIDE
Approving Commander:____________ Date____________
SHAWNEE POLICE DEPARTMENT
CIVILIAN OBSERVER PROGRAM
RULES AND GUIDELINES
NAME
DATE OF BIRTH
I have read, understand, and will comply with each of the below listed rules. I also
understand failure to observe any rule or directive by a Shawnee Police Officer will cause
an immediate termination of my approval as a civilian observer.
1.
Do not get out of the police vehicle on calls unless given permission to do so by the
officer. Initials_______
2.
Do not try to assist the officer unless requested to do so under extreme circumstances.
Initials ______
3.
Do not talk with suspects or other civilian persons in the vehicle or police department.
Initials _______
4.
Obey all instructions given by the police officer(s) present. Initials _____
5.
The residential privacy rights of citizens outweighs any reasons for any civilian to go into
a private residence while participating in a police ride along program. Therefore, under
no circumstances may a person participating as a civilian observer enter onto or into any
private residence including the house, yard, or other buildings on the citizen's property.
Initials_______
6.
Participants will not be allowed to carry any type of weapon unless the
individual is a certified law enforcement officer. Initials______
7.
Participants may not use cameras and/or recording equipment during their ride except as
approved by the Chief of Police or his/her designee. Any photograph, audio, or video
taken by a participant shall not be posted to social media or transmitted, and may be
seized as evidence as necessary. Initials______
8.
Participants are to be dressed appropriately. Shorts, sandals, or bare feet are not
acceptable dress. Shirts and jackets shall not contain any inappropriate or controversial
language, symbols, or pictures. Initials_______
PARENT SIGNATURE
CIVILIAN OBSERVER SIGNATURE
PARENT SIGNATURE REQUIRED FOR ALL PERSONS UNDER THE AGE OF 18.
---------------------------------------------------------------------------------------------------------------------------------------------------------------To be completed by Shawnee Police Officer on day of ride:
OFFICER ON DUTY:
DATE:
TIME:
SHIFT:
UNIT:
FROM:
TO: