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Woodland Youth Public Safety Academy Registration

Steps

  1. 1. Step One
  2. 2. Insurance Waiver and Release of Liability
  3. 3. Cadet Photo Release Waiver
  • Step One

    1. Woodland PD Patch (PNG)

    2. Woodland Youth Public Safety Academy Registration

      Application Instructions: Please complete the following online registration form. Make sure to provide all requested documents. The Academy is limited to 20 cadets. Open positions will be filled on a first come, first serve basis.

    3. WFD patch

    4. Cadet Information

    5. SPRING 2021 - SESSION #6

    6. Parent / Guardian Information

    7. Parent #1

    8. Parent #1

    9. Parent #2

    10. Parent #2

    11. If different than Cadet - list above.

    12. Emergency Contact Information

      Please list an emergency contact (other than a parent) that can be contacted if the parent's are unreachable:

    13. Cadet Personal Health History

      To be filled out by Parent or Guardian about Cadet.

    14. Allergies*

      Does your Cadet have allergies to food, medicines, insects, plants, other?

    15. General Information*

      Please select Yes or No:

    16. Prescription or Over-The-Counter. List N/A if none.

    17. List N/A if none.

    18. Immunizations

      Please provide the date of the last inoculation or attach the Cadet's shot record.

    19. Parent Authorization*

      This health history is correct so far as I know, and the person herein described has permission to engage in all prescribed activities associated with the Woodland Youth Public Safety Academy, except as noted by me in writing. I have received and read the Insurance Waiver- Release of Liability. In the event of illness or accident in the course of such activity, I request that measures be instituted without delay as the judgment of medical personnel dictates.

    20. Electronic Signature Agreement

      By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.