Release Form

Prospect Park Police Department

Junior Police Academy
Release Form
I, the undersigned parent/guardian of Residing at .
Do hereby give my son/daughter permission to attend the Prospect Park Jr. Police Academy and in consideration of allowing him/her to participate in the above name program I voluntarily and knowingly release and discharge the Jr. Police Academy, Prospect Park Police Department, Prospect Park School and all instructors and participants in this program as well as all others who may be liable from all claims, present, and future, known or unknown, in any manner arising out of his/her participation in the Jr. Police Academy.

I also authorize the Jr. Police Academy instructors to render any and all emergency assistance to my child in the event same is needed.
I acknowledge that has no limiting medical conditions and is fully capable of participating in the program. This hold-harmless agreement is a testament to my understanding of the above evidence by my signature.
Parent/Guardian Signature

Clear
NameParent/Guardian Print Name
Please contact the following individual(s) in the event of an emergency:
Name
Telephone number
Should be Empty:

Prospect Park Police Department