GRAFTON POLICE YOUTH ACADEMY (2023)

GRAFTON POLICE YOUTH ACADEMY (2023)

August 7th to August 11th
The Grafton Police Department seeks to provide innovative and effective programs for the youth in our community. The Youth Police Academy is such a program! It is designed to establish a positive relationship between the Grafton Police and the youth in our community. There is no cost to attend the academy and size is limited to 24 participants. All cadets need transportation to the Grafton Police Department each morning (no earlier than 7:45am) for an 8:00am start. Cadets are to be picked up each afternoon from the Grafton Police Department promptly at 3:00pm unless otherwise specified.

Goals of the Grafton Youth Police Academy:
- Enhance responsible citizenship.
- Provide positive interaction with police officers and educate young people about the challenged and responsibilities of police work.
- Provide team building activities to instill positive qualities in the student cadets.
Eligibility to attend:
- Be entering 7th or 8th grade
- Be a non-smoker
- Be a resident of Grafton
- First time applications will be given preference over students who have previously attended.
Classes will be held at the Grafton Police Department. Cadets will attend morning classroom sessions with lectures, role-plays, and interactive demonstrations by police officers of the Grafton Police Department in the areas of Motor Vehicle Law, CPR and First Aid (to include Life Flight), Defensive Tactics, Applied Patrol Procedures, Drill and Ceremony, Drug Recognition and Gun Safety – just to name a few. Cadets will participate in PT (Physical Training) each day.
Program will run from 8:00am to 3:00pm at the Grafton Police Department. Parents, this is a one-week commitment and attendance is mandatory. This is due to the number of applicants wanting to attend.

Water will be provided by the Grafton Police Department but Cadets must bring their own lunch.

Please call or email with any questions regarding the Academy at:

School Resource Officer Mark Alves

774-666-0236 or youthacademy@graftonpolice.com
INSTRUCTIONS ON HOW TO APPLY
- Complete Cadet Application
- Write a paragraph on why you wish to attend
- Complete and sign Student Contract
- Complete and sign Permission Slip – Parent/Guardian
- Complete and sign Release of Liability – Parent/Guardian and Student
- Complete and sign Emergency Contact Form - Parent/Guardian and Student
- Complete and sign Authorization to Take and Use Photographs/Video and Waiver and Release of Claims
CADET APPLICATION

Cadet Information
Cadet's Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Birth Date*

MonthDayYear
Age*
Incoming Grade*
Gender*

MaleFemale
Adult Shirt Size (pick one)*

SmallMediumLargeXtra Large
If you require an adult size please specify here:
Why do you wish to attend...
Please complete the entire application and answer all questions

This program is partially funded through Together We Can and the Grafton Police Department.

School and Community Information Request:

Truancy:
- Less than 3 absences per semester without reason
- More than 3, but less than 8 absences per semester without reason
- More than 8 absences per semester without reason
Date*

MonthDayYear
Date
Parents Signature*

Clear

CADET CONTRACT
I am willing to abide by the conditions and regulations set forth by the Grafton Youth Police Academy. I realize that failure to comply with these rules may result in termination from the Grafton Youth Police Academy.
Date*

MonthDayYear
Date
Cadet Signature*

Clear
Parent/Guardian Consent *

Clear

PARENT/GUARDIAN PERMISSION SLIP

Permission of the Parent or Guardian is mandatory for applicants.
I, (print) name* am the Parent/Guardian of (print)name* hereinafter referred to as the (CHILD). I am over 18 years of age and reside at address*.
In consideration of and for the permission and authority of my CHILD to participate in the Grafton Youth Police Academy which includes classroom instruction, field trips and physical activities, I hereby release and forever discharge, and shall hold harmless and indemnify the Grafton Police Department and or The Town of Grafton –and its agents, servants and employees (collectively hereinafter referred to as the HOST) from all actions, causes of actions, suits, debts, sums of money, accounts, damages, judgments, claims and demands whatsoever which I or my CHILD, or our heirs, executors, administrators, successors, and assigns may have now or in the future against the HOST arising out of my CHILD’S participation in the Grafton Youth Police Academy including, but not limited to the aforementioned activities and any acts related thereto. This release may not be changed orally.
Date*

MonthDayYear
Date
Parent/Guardian Signature*

Clear
Application will not be accepted if not accompanied by Parent/Guardian signature.

EMERGENCY CONTACT INFORMATION

Parent/Guardian Information
Participant Name*

First NameLast Name
Participant Cell Phone*
Primary Emergency Contact
Emergency Contact's Name*

First NameLast Name
Relationship*
Cell Number*
Daytime Number
Evening Number
E-mail*
example@example.com
Alternate Emergency Contact
Emergency Contact's Name*

First NameLast Name
Relationship*
Cell Number*
Daytime Number
Evening Number
E-mail*
example@example.com
I verify this information is correct:
Date*

MonthDayYear
Date
Signature*

Clear

AUTHORIZATION TO TAKE AND USER PHOTOGRAPHS/VIDEO AND WAIVER AND RELEASE OF CLAIMS
I, blanks*, hereby grant the Grafton Police
Department, its directors, officers, employees, agents, and designees (collectively “GPD”) non-revocable permission to capture my image and likeness in photographs, videotapes, motion pictures, recordings, or any other media (collectively “Images”). I acknowledge that GPD will own such Images and further grant the GPD permission to copyright, display, publish, distribute, use, modify, print and reprint such Images in any manner whatsoever related to GPD business, including without limitation, publications, advertisements, brochures, web site images, social media or other electronic displays and transmissions thereof. I further waive any right to inspect or approve the use of the Image by the GPD prior to its use. I forever release and hold the GPD harmless from any and all liability arising out of the use of the Images in any manner or media whatsoever, and waive any and all claims and causes of action relating to use of the Images, including without limitation, claims for invasion of privacy rights or publicity.

I hereby certify that I am the parent and/or guardian of a child under the age of 18 years, and hereby consent that any Images (as defined above) may be used for any purposes set forth in this Authorization and Release above.
Date*

MonthDayYear
Date
Participants Name*

First NameLast Name
Parent/Guardian Name*

First NameLast Name
Parent/Guardian Signature*

Clear
Confirmation BY ACKNOWLEDGING AND SIGNING ALL FORMS, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Should be Empty:

Now create your own Jotform - It's free!Create your own Jotform

GRAFTON POLICE YOUTH ACADEMY (2023)

INSTRUCTIONS ON HOW TO APPLY

CADET APPLICATION

CADET CONTRACT

PARENT/GUARDIAN PERMISSION SLIP

PARTICIPANT RELEASE OF LIABILITY

EMERGENCY CONTACT INFORMATION

Primary Emergency Contact

Alternate Emergency Contact

AUTHORIZATION TO TAKE AND USER PHOTOGRAPHS/VIDEO AND WAIVER AND RELEASE OF CLAIMS