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2024 Summer Youth Police Academy is a six (6) week program comprised of 14 different site locations citywide. If more than one of your children is applying to the Academy, A Separate and Complete Application MUST Be Submitted for EACH Child

Child Information

Child Last Name

Submission ID

Child First Name

Age

Gender

Child's Date of Birth

Address

Apartment #

City

State

Zip Code

Name of School Child Attends

Attended Prior

City Housing Resident

Child's Shirt Size Youth

Adult Size

Select Academy Campus Closest to Your Home

Have you submitted separate application for other children?

NoYes

Full Name of other child

Full Name of other child (2)

Full Name of other child (3)

Review and Submit

Home Phone

Alternate Emergency Number

Parents E-mail Address

Permission of the Parent/Guardian is Mandatory for Applicants

In consideration of, and for the permission and authority of my CHILD to participate in the Youth Police Academy, which includes classroom instruction, field trips, recreational events, sporting events and physical activities, I hereby release and forever discharge and shall hold harmless and indemnify the City of New York Police Department, the City of New York and its agents, servants and employees (collectively hereinafter referred to as the City) from all actions, causes of action, suits, debts, sums of money, accounts, damages, judgments, claims and demands whatsoever which I or my CHILD, or ours heirs, executors, administrators, successors and assigns may have now or in the future against the City arising out of my CHILD’s participation in the Youth Police Academy including, but not limited to the aforementioned activities and any acts related thereto. This release may not be changed orally.

Terms & Conditions

My CHILD agrees to follow the rules of conduct outlined by the Youth Police Academy. Failure to do so may result in suspension from participation. I, the undersigned parent/guardian/participant do here by grant authority to the staff of the Youth Police Academy a judgment concerning medical assistance or hospital care in the event of an accident or illness during my absence. I do hereby authorized the Youth Police Academy and its assigned to utilize any and all photographs, videos or other likeness of my CHILD, as they deem appropriate in its promotional materials or team films. Due to limited services/providers, applicants that have a Department of Education One on One Individualized Educational Plan or physical disabilities that prohibits the CHILD from performing physical training will not be permitted to participate in the program.

Full Name

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