Police and Youth Together

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, on or off The Dayton
Fraternal Order of Police Lodge #44 property and the Trotwood YMCA as the Trotwood Lodge, 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.

NCCJ is in constant communications with public health to determine the safest way to host PAYT. Safety will be of the highest priority when planning camp. This may include required masking, sanitizing, etc. As we identify the current needs of the pandemic, we will be sending out a list of detailed COVID precautions as we approach a camp.
I understand that while precautions are being taken, the risk of COVID is still present.
I agree to monitor my camper for COVID symptoms and to not bring them to camp if they display, describe, exhibit any symptoms or if anyone in our household does.
I understand that if anyone in my household tests positive for COVID, my camper should remain home
I understand that NCCJ has the right to send my camper home if they begin to have symptoms of COVID, have a fever over 100.4 degrees
I understand that camp plans may change due to current public health standings

 I have read the application and give consent for my child to attend the 2024 Police and Youth Together Camp at Miami Valley Academies located at 5656 N. Springboro Pike #280, Dayton Ohio, 45449 during the above selected date.

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