Mountain View Fire & Rescue
King County Fire Protection District 44
Dedicated to the Public We Serve
CIVILIAN RIDERS REQUEST
ALL REQUESTS, WAIVERS AND OTHER ATTACHED FORMS MUST BE
COMPLETED BEFORE APPROVAL
CIVILIAN RIDERS
PROCEDURE
Any Civilian who wishes to ride on Fire Department apparatus and/or vehicles shall comply with the
following procedures:
1. Submit a signed waiver of liability to the Fire Chief.
2. Submit a waiver at least two days in advance of the date the person is requesting to ride.
3. Submit a Riders Request completed and signed to the Fire Chief.
4. Submit Riders Request at least two days in advance of the date the person is requesting to
ride.
5. Read and sign the Riders rules, regulations, and conduct form.
The Fire Chief or his designate shall:
1. Approve or disapprove the request to ride.
2. Make arrangements to contact the rider and verify times and dates.
3. Assign rider to appropriate apparatus.
4. Forward original waiver to clerical staff for filing.
5. Forward a signed, Riders rules, regulations, and conduct form along with any other special
instructions to the crew and/or officer that the rider will be riding with.
6. May grant special permission for unusual situations, issue special instructions and/or
restrictions based upon his/her sole discretion.
King County Fire Protection District 44
Mountain View Fire & Rescue
32316 148 Ave SE, Auburn WA 98092
RIDERS REQUEST
Date Submitted: __________________________________________
DATE REQUESTED
Day: ________________ Month: ____________________________________________
Year:_____________
Name: ________________________________________________________________________
Address: ______________________________________________________________________
______________________________________________________________________
Contact Phone Number: __________________________________________________________
I am 18 years of age or over: YES 
NO 
*Please give a brief statement of why you wish to ride with the Fire Department.
(REQUIRED)
Sponsoring Fire Fighter: __________________________________________________________
Signature: ____________________________________________________ Date: ____________
OFFICE USE
Approved 
Disapproved 
Fire Chief’s Signature: _______________________________________________
Date: _________________
King County Fire Protection District 44
Mountain View Fire & Rescue
32316 148 Ave SE, Auburn WA 98092
RIDERS RULES, REGULATIONS, AND CONDUCT
1. Riders shall be dressed in appropriate attire. Clean uniforms, pants, and/or blouse. No tshirts with inappropriate graphics or writing are allowed. Riders must be dressed in a neat
and clean manner. No baseball type hats are to be worn.
2. The rider will ride only in and with the assigned crew and apparatus. The person in charge
can assign other temporary arrangements should the need to transport the rider back to the
station or other location arise.
3. The rider will follow all requests made of him during the time that he/she is in the station, on
apparatus, or at the scene of an incident.
4. The rider will not be allowed to enter any dangerous location, operate dangerous
equipment, or directly participate in any emergency activities or drills that could be
dangerous or cause harm to the rider. Riders will not be allowed to drive or operate any
vehicles or apparatus.
5. If requested by Fire Department personnel, the rider will remain in the apparatus or at the
station during any routine or emergency response.
6. Riders will be allowed to only ride with career personnel and during the hours that career
personnel are on duty.
SPECIAL INSTRUCTIONS:
Riders Signature: ____________________________________ Date: _________________
Fire Chief’s Signature: ________________________________ Date: _________________
King County Fire Protection District 44
Mountain View Fire & Rescue
32316 148 Ave SE, Auburn WA 98092
EMERGENCY VEHICLE RIDER
WAIVER/RELEASE
In consideration of receiving permission from King County Fire Protection District 44, Mountain View
Fire & Rescue, to ride as an observer in Emergency Vehicles, owned and operated by the Fire
District during Emergency and Routine responses and business, the undersigned hereby releases
King county Fire Protection District 44, its Commissioners, agents, officers, and employees of and
from any and all liability, claims, demands, actions, and causes of action arising out of or related to
any loss, damage or injury, including death, that may be sustained by the undersigned, or any
property of the undersigned while in or on the premise of the District or in any emergency vehicles
owned or operated by the District.
The undersigned is aware of the risks and hazards inherent in riding in emergency vehicles while
responding to or returning from an emergency response call. The undersigned hereby elects
voluntarily to enter the District premises and occupy District vehicles and assumes all risks that may
be sustained during such activity.
This release shall be binding upon the heirs and personal representatives of the undersigned.
Dated this: _____________ day of: _______________________________________,
20 __________________.
Signature: ______________________________________________________________________
Witness: _______________________________________________________________________
NOTE: IF THE ABOVE SIGNED PERSON IS UNDER THE AGE OF EIGHTEEN (18) YEARS OF
AGE, THE PARENTS OR LEGAL GUARDIANS OF THE ABOVE SIGNED MUST ALSO SIGN
THIS RELEASE, APPROVING OF, GIVING PERMISSION, AND AGREEING TO ANY AND ALL
PARTS OF THE ABOVE RELEASE.
Signature: ____________________________________ Date: ____________________________
Relation: _____________________________________
Signature: ____________________________________ Date: ____________________________
Relation: __________________________________________________
THIS FORM MUST BE ATTACHED TO WAIVER
INFECTIOUS DISEASE
BLOODBORN PATHOGENS
BIO HAZARDS
Emergency medical and or other related incidents can expose emergency workers and any other
personnel to potential contamination by infectious diseases and/or Bloodborn pathogens, this
includes but is not limited to; HIV, AIDS, Hepatitis, TB, and many other related life threatening
diseases. Many of these infectious diseases have the potential to cause illness and death.
At no time will a civilian rider be allowed at or places in a situation that contributes to exposure of
infectious disease or bloodborn pathogens.
Fire Department personnel are specially trained and provided with protective equipment and
inoculations to protect from Bio Hazards.
Civilian Rider will NOT:
Enter areas that have potential BIO HAZARDS.
Ride in or enter contaminated or potentially contaminated Fire Department Vehicles.
Enter emergency scenes that are contaminated or potentially contaminated.
Be exposed to, handle or in any other way make contact with, any Bio Hazard materials,
contaminated or potentially contaminated areas, vehicles, incident sites or equipment.
Enter any to any area, vehicle or space that has potential contamination from or by victims, patients,
or other infectious, contaminated or potentially contaminated persons.
It shall be the responsibility of Fire Department personnel to see that Civilian Riders are not placed
in or at contaminated or potentially contaminated areas.
It shall be the responsibility of Civilian Riders to follow the direction of the Fire Department
personnel to prevent exposure to Bio Hazards.
Signature Civilian Rider: ____________________________________ Date: _______________
Guardian Signature: _______________________________________ Date: _______________