Georgetown Police Department 2018 Junior Police Academy Application

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Georgetown Police Department Application Application Deadline: Friday, April 27, 2018 by 5:00pm. There are 25 slots available for each camp, so don t delay in turning in your application. Applications will be accepted on a first-come, first-served basis. Applications need to be hand delivered to the Reception Desk at 3500 DB Wood Road, Georgetown, TX 78628. The applications can also be mailed, but please note that using this method of delivery could cause a delay in receipt and your child may not be accepted. Purpose: The Georgetown Junior Police Academy is a camp designed to strengthen the connection between law enforcement and local youth, giving them a chance to see what it s like to become a cadet police officer over their summer vacation. Please complete and attach the APPLICATION, MEDICAL INFORMATION SHEET, PARENTEAL RELEASE, AND RELEASE OF LIABILITY, for each child attending. Application packets must be turned into the Public Safety Operations and Training Facility, located at 3500 DB Wood Rd, Georgetown, TX 78628. Applications will be date and time stamped so your quick response is appreciated. A waitlist based on date/time that application is received will be kept for any cancellations. This FREE camp is modeled after the police academies that adults attend to become sworn peace officers. Our academy is geared to accommodate Georgetown students, ages 8 to 14 years old. The camp is conducted from 8 a.m. to 4 p.m. at the Georgetown Public Safety Operations & Training Facility, located at 3500 DB Wood Rd., Georgetown, Texas 78626. The academy has aspects of a paramilitary organization; Junior Cadets will be introduced to physical training such as: competing in an obstacle course, marching, and repelling. Cadets also get a first-hand look inside equipment such as a fire truck, patrol and SWAT vehicles, and a police helicopter. The camp s curriculum includes traffic safety, criminal investigations, and alcohol and drug use. Cadets will also participate in hand-cuffing and self-defense tactics. Cadets will take field trips and have an opportunity to go swimming, and speak to other community helpers. At the end of the academy, students will participate in a graduation ceremony that acknowledges their endurance and hard work. Academy Rules: To ensure the safety of all, participants are expected to follow the rules and guidelines. We wish for the academy to be a fun and enjoyable experience for all who attend. Cadets will be expected to maintain a respectful attitude towards classmates and instructors.

Cadets will adhere to a no touch policy. Cadets are expected to keep up with their personal belongings and should limit what they bring to class only to the items needed. Electronic devices may not be used or visible. Please leave them at home. Cadets will be expected to participate in all class activities. If a cadet is unable, instructors should be given notice of the cadet s physical limitations prior to the start of the academy. Uniform: Wear black shorts and the issued JPA t-shirt. Please note these may need to be washed nightly. Socks and athletic shoes should be worn each day. Shorts must extend to fingertip length when standing and no longer than the bottom of the knee. Violation of the rules may result in removal from the class for the day. Subsequent violations may result in expulsion from the academy. Things to Remember: Time: 8 a.m. to 4:00 p.m. Monday Thursday. Cadets will be released following the graduation on the last day at approximately 4:00 p.m. Location: Georgetown Public Safety Operations & Training Facility, located at 3500 DB Wood Rd., Georgetown, Texas 78626. Daily Packing List: Refillable Water Bottle Sunscreen Snack Lunch (except for Friday) Dress in Black Shorts (Shorts must extend to fingertip length when standing and no longer than the bottom of the knee). Also, shorts must be worn as intended. Wear socks and athletic shoes. Wear plain t-shirt the first day Wear issued JPA t-shirt (once issued) Tuesday through Friday No cell phones or electronic devices will be used or visible during the academy times. If you need to get in touch with your child during the day, you may contact a Junior Police Academy Advisor at (512) 930-3510.

JUNIOR POLICE ACADEMY APPLICATION 1. What is your child s full legal name and date of birth Name: Date of Birth: 2. What is your child s age? 3. What is your child s gender? Male Female 4. Are you a current City of Georgetown employee? 5. Are you are a currently residing within the City Limits of Georgetown? 6. Please place a check next to the camp you wish your child to attend; each applicant should use a separate application. Only one camp is allowed per child per summer. June 11 14 (Ages 8-10) June 18 21 (Ages 11-12) July 9 12 (Ages 13-14) July 16 19 (Ages 11-12) July 23 26 (Ages 8-10) 7. T-Shirt Size: (we cannot change sizes once ordered) Youth Small Youth Medium Youth Large Youth X-Large Adult Small Adult Medium Adult Large Adult X-Large 8. Can your child swim? Georgetown Police Department

9. What are your child s hobbies/interests? 10. Does your child attend GISD? Home schooled 11. EMERGENCY CONTACT: Name 12. EMERGENCY CONTACT: Address 13. EMERGENCY CONTACT: Phone 14. Does your child have any medical condition or under physicians care? If yes, please explain: I certify that the above information is true correct to the best of my knowledge. Parent Name Parent s Phone # Parent Signature E-mail address

Georgetown Police Department MEDICAL INFORMATION PLEASE PRINT Date: Name of Participant: Date of Birth: Please list ANY medical conditions that the participant has: List ALL medication taken by the participant: Is the participant required to take medication during the academy hours? Yes No If yes, what is the medication/dosage? Is the participant able to administer the medication? Yes No If no, please explain: PHYSICIAN: PHONE: DENTIST: PHONE: Parent/Guardian Address Cell Phone Home Phone Employer Phone Note: All medical emergencies will be treated as such and will be attended to by the Georgetown EMS/Fire Department as deemed necessary by academy personnel, instructors, or coordinators.

GEORGETOWN POLICE DEPARTMENT PARENTAL CODE OF CONDUCT & MEDIA RELEASE I, (Parent), give permission for my child to participate in the Georgetown Police Department s Junior Police Academy being held on (date). I understand that my child will be attending classes supervised by Georgetown Police Department personnel. I also understand that the supervised classes will consist of both educational and practical material and that some of the material in the classes may be graphic due to the nature of the curriculum or class topic. I have read the rules of conduct and dress code and understand that both must be adhered to at all times. The undersigned does also herby authorize photographs and or video documentation to be taken of my son / daughter. Photographs and or videos may be used to promote or further the Georgetown Police Department s Junior Police Academy, and may be used in the media. (Parent / Guardian signature) (Date)

GEORGETOWN POLICE DEPARTMENT RELEASE OF LIABILITY WAIVER I, (Parent), hereby authorize my son/daughter to participate in the Georgetown Police Department s Junior Police Academy. The camp will take place on (list date). I,, also give my permission for my son/daughter to be transported to and from scheduled and specified events by vehicles operated by Georgetown Police Department personnel. I,, fully understand, and my son/daughter fully understands, that participation and transportation during the Georgetown Police Department s Junior Police Academy could result in bodily injury, serious bodily injury, illness or death. Although I fully appreciate these risks, I desire my child to participate in the Georgetown Police Department s Junior Police Academy without regard of the consequences. I, the undersigned, assume full and complete responsibility for any accident, injury or illness and or activity that may occur to my child as a result of their participation. I agree to and hereby release, hold harmless, and waive all claims that I, or my child may have against the Georgetown Police Department, City of Georgetown, or any of its employees, agents, sponsors, representatives, or volunteers from all legal injury, illness or death and or activities arising from or connected in any manner to my child s participation in the Georgetown Police Department s Junior Police Academy, including but not limited to liability, damages, legal fees and or costs caused by or related to the negligence or the intentional act of the Georgetown Police Department, City of Georgetown, or any of its employees, agents, sponsors, representatives, or volunteers in whole or in part. This release shall be binding on my heirs, legatees, administrates, and assigns. (Parent/guardian signature) (Date) (Parent/guardian Printed Name)