2026 Warwick Youth Leadership Camp Application

Allergies

Please indicate below if your child is allergic to anything.
Food Allergies - Please describe the allergy and the reaction the child experiences*
If none, type N/A
Other Allergies & Reaction (Explain in detail)
Please list all medications your child is currently taking
Medication(s), Dosage & Frequency*
If none, type N/A
Is there any other information the camp staff should know about concerning your child that may be pertinent to their health, well-being or comfort?
YesNo

City of Warwick

Warwick Police Department 99 Veterans Memorial Drive Warwick, Rhode Island 02886-4617 Telephone: (401)468-4200
RELEASE

Please Read and Sign Below
KNOW ALL MEN BY THESE PRESENTS, that I do hereby remise, release and forever discharge and quitclaim unto the said City of Warwick, the Board of Public Safety of the City of Warwick, the Warwick Police Department and their duly authorized agents, servants and employees, their heirs, executors, administrators, successors and assigns, from any and all manner of actions, cause of action, debts, obligations, claims or demands, both in law and in equity which I/we now have, ever had or in the future may have against the City of Warwick the members of the Board of Public Safety of the City of Warwick, the Warwick Police Department and their duly authorized agents, servants and employees for or by reason of, Youth Leadership Camp OR BY REASON OR MEANSOF ANY matter or thing from the beginning of the world to the date of execution hereof. I/we hereby acknowledge and assume all risk, chance or hazard of bodily injury and property damage which may result tome/us in the connection with my/our voluntary participation in the activities of the Warwick Police Department as sanctioned and authorized by the City of Warwick, the Board of Public Safety of the City of Warwick, the Warwick Police Department and their duly authorized agents, servants, and employees. I/we further acknowledge that I/we have carefully read the foregoing release and know contents thereof, and I/we the same as my/our free act and deed.*
Parent/Guardian's Name*
MINOR (CHILD) PHOTO RELEASE FORM
I, the parent or legal guardian grant the City of Warwick Youth Leadership Camp my permission to take/use the photographs taken during camp activities for publicity, local news spot-light, City of Warwick or Warwick Police Department web content/promotions.

Furthermore, I understand that no royalty, fee, or other compensation shall become payable to me by reason of such use.
Parent/Guardian's Signature*
Date*

MonthDayYear
Date
Parent/Guardian's Name*
Child's Name*
2nd registered child's name
3rd registered child's name
Phone Number*
Format: (000) 000-0000.
File Upload: 2-3 paragraphs in Word or PDF document for each registered child *

Cancelof
Application Requirements & Information

1. Application Packet: Parent and Youth Information

2. Medical Release Form: This form must include a note from your child's physician indicating that the child is capable of attending this camp.

3. Photo Release: Photos may be taken during our camp.

4. Word document with 2-3 paragraphs from the student describing oneself and why the interest in attending leadership camp.

5. Camp Fee: Payment can be paid online or by check or money order. The $50 fee covers all expenses associated with this camp. Make checks payable to Warwick PAL. Financial aid is available. Follow this link to apply https://form.jotform.com/WarwickPAL/Financial_Assistance

If the camp is full and you are not accepted, you will be promptly refunded.

Items campers should bring with them each day:
1. Bug repellant
2. Sunscreen protection
3. Rain gear
4. Sweatshirt
5. Bathing suit & towel
6. Medication(s) IMPORTANT Medication (such as inhalers and epi-pens) MUST BE CARRIED ON THEIR PERSON!!!
The majority of activities will take place in controlled environments, but please keep in mind that some of the activities can take place in a wooded area containing ticks and thick briar bushes, so try to wear light-colored clothing. Also, be prepared for bad weather.

If you are unable to attend the Leadership Camp, please notify us at least one week prior to the start of the camp. Failure to do so will result in the forfeiture of your deposit.

To make notifications or to ask questions, please contact Officer Nia Pina at wpdsummercamp@warwickri.gov.
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