Cop Camp Application

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Please complete the form below to register for Cop Camp. You can also download the form in Spanish here. 
Please correct the field(s) marked in red below:

1
Applicant's full name: 
 *
2
Address:
 *
3
Sex:
 *
4
Date of Birth: 
 *
5
Age: 
 *
6
School and current grade:
 *
7
Parent/Guardian full name:
 *
8
Relation to child:
 *
9
Home phone number:
10
Cell phone number: 
 *
11
Work phone number: 
12
Email: 
 *
13
Please list any physical limitation that might impact the child's participation: 
14
Person making referral (Please list name, relation/position, school and phone number):  
 *
15

Which session of Cop Camp are you applying for: 

 

Which session of Cop Camp are you applying for:
  1. To receive a copy of your submission, please fill out your email address below and submit.