PAYT Neighbors

Camper Agreement
For everyone to have a great experience at camp, please read and sign below:

 I will join in all the activities during the Police and Youth Together Camp.

 I will respect everyone, their belongings, and their space.

 I understand that if I don’t follow the rules, NCCJ will call my parent/guardian.

I have read and agree to the above.

I certify that the information provided is correct and complete so far as I (the undersigned) know, and the person herein described as the student has permission to engage in all prescribed camp activities except as noted on this health form. I understand that it is the
responsibility of the parent/guardian to inform The National Conference of Community and Justice of Greater
Dayton of any changes or additions to this form on the day the child arrives at camp. I also certify that the above-named camper has received a health exam from a licensed medical personnel within the past 24 months of time before the camper will be at camp. I have listed any physical condition requiring restrictions on participation in the camp program and a description of such restrictions. I have also listed any current or ongoing treatments or medications.

 I have read the application and give consent for my child to attend the 2019 Police and Youth Together Camp at the Fraternal Order of Police Lodge #44 on 4275 Powell Road in Huber Heights from July 29 - August 2, 2019.

 I give NCCJ of Greater Dayton, RTA and participating Police Agencies to transport my child to and from PAYT at the F.O.P. Lodge and for scheduled follow-up sessions throughout the year.