Police and Youth Together

NCCJ Youth Programming

Police and Youth Together!

Police and Youth Together (PAYT) is a free week-long day camp for students ages 10 to 13. PAYT is offered in collaboration with local area law enforcement agencies from across the Miami Valley. PAYT builds bridges between police and youth as well as their families, teaching respect and encouraging an appreciation of diversity. During PAYT, youth learn valuable leadership skills, such as how to accept differences, and to disagree respectfully. In addition to fostering a collaborative learning environment, PAYT also promotes relationship development between officers and youth through outdoor games, art projects, and crafts.

In 2023, PAYT will take place twice. We will host one spring break camp and one summer camp. NCCJ also offers a year of follow up activities happening once a month for all PAYT campers and officers.

2023 PAYT Dates:

April 3 – 7, 2023 (Stebbins High School)

July 24 – 28, 2023 (Dayton FOP)

Register for PAYT

Please Note: PAYT Registration may fill quickly. Be sure to register to secure your space!

Step 1 of 3

Camp Agreement
Please agree to the following camper agreement:*
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 agree to the camper agreement
Media Release
I hereby consent to having quotes of my child’s comments, pictures and/or video footage in which they will appear to be used by NCCJ and Police and Youth Together for publicity purposes. We release NCCJ and sponsoring agencies from any obligation or liability arising from use of said comments, pictures or videos.

If you wish to NOT have your child photographed or quoted, please do not select this field.
Please select if you agree with the media release

Student Health Information
(1) If parent/ guardian is not available, please contact:*
First Last
(1) Emergency Contact Relationship to Student*
(1) Emergency Contact Phone*
(2) If parent/ guardian is not available, please contact:*
First Last
(2) Emergency Contact Relationship to Student*
(2) Emergency Contact Phone*
Please list the students physician and dentist names as well as a contact phone number:*
Does the student take medication?*
- Yes
- No
What Medications?
Please list any medications that the student takes
Please list any health conditions or operations/ serious injuries that the student has had (type NA if none)*
Enter any medical conditions (i.e. ADD, Asthma, Seizures, Etc.) and serious injuries or operations the student has had (i.e. broken arm)
Does the student have all required school immunizations up-to-date?*
- Yes
- No
Health Exam*
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.

I certify the information is correct
Consent To Treat
I give permission to NCCJ and the Police and Youth Together staff to provide routine health care, administer prescribed medications, and seek emergency medical treatment which may include the administration of over-the-counter medications such as, acetaminophens (Tylenol) and topical ointments.

If you do not give permission to NCCJ to administer routine health care, please do NOT select this box.
I give permission to NCCJ
COVID Understanding*
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 Understand the following
Parent Notification
Parents/guardians will be notified of an accident/injury/illness of their child if the accident/injury/illness requires any significant medical attention such as, but not limited to, a stay in the health center of more than three hours, possible sprain/strain/fracture/broken bone/concussion/need for stitches, a temperature of 100 degrees or more, any loss of consciousness, or the need to visit a doctor. NCCJ does not provide accident/health insurance. You can file any medical bill incurred with you insurance company.
Parent/ Guardian Consent*
 I have read the application and give consent for my child to attend the 2023 Police and Youth Together Camp at the Fraternal Order of Police Lodge #44 on 4275 Powell Road in Huber Heights or at the Trotwood YMCA 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 the F.O.P. Lodge or Trotwood YMCA and for scheduled follow-up sessions throughout the year.

I have read and agree with the terms
PLEASE SUBMIT APPLICATION
Thank you for submitting your application for Police and Youth Together. An NCCJ Associate will reply within two business days to verify we have received your application. If you have any questions, please contact us at payt@nccjgreaterdayton.org or by calling 937-222-6225.
Email
This field is for validation purposes and should be left unchanged.

Program made possible by the Montgomery County ADAMHS Board

Police and Youth Together

NCCJ Youth Programming