FORT WORTH POLICE DEPARTMENT
Explorer Annual Academy
June 10th-14th, 2013
Important Information
Fort Worth Police Department Explorer Annual Academy is scheduled to be held June 10-14, 2013.
NOTICE: A background check is required for admission and will be conducted prior to acceptance into the
academy. Please make sure your completed registration forms, fees and tuition, medical form, Explorer interest card
and all waivers are turned in early (by May 31) to ensure that your background check will be complete in time for
registration. SPACE IS LIMITED THIS YEAR TO 80 PARTICIPANTS.
Registration will be from 1-4 p.m. on Sunday June 9, 2013 at the Fort Worth Police and Fire Training Academy
located at 1000 Calvert St, Fort Worth, TX 76107. The complete Explorer application, medical release, academy
registration form and waivers must all be signed and turned in along with required fees completed and you must be
approved by the Youth Services Coordinator prior to attending the academy. There is a $25 registration fee for the
Explorer program. The academy tuition is $25. A total of $50 will be due for students beginning their Explorer
experience with the academy.
All new Explorer applicants are required to attend this academy and complete the entire academy prior to being
allowed to join a FWPD Explorer post. The academy will consist of daily physical, classroom, hands-on scenario and
teambuilding training. A final physical assessment will be administered on the last day. Upon completion of the
academy and passing the final physical assessment, applicants will be released to join a FWPD Explorer post.
The schedule will be from 0730-1730 hours (7:30 a.m. to 5:30 p.m.) each day. All parents must pick up their
youth at the FWPD Police and Fire Training Academy each day by 5:45 p.m. NO meals will be provided. Each
youth must bring their own lunch each day. Please make sure to eat breakfast before arrival.
Sunday: 1:00-4:00 p.m. - Registration at FWPD Training Academy located at 1000 Calvert St, in the Activity Room.
Each participant will receive an Explorer T-shirt (to be worn during the academy), schedules, instructions and rules. A
list of items needed for physical training (PT) will also be distributed.
Monday: 7:30 a.m. - Show up in PT gear ready to do physical training. You must bring your issued t-shirts from
registration to wear after shower and PT. Please make sure to bring complete change of clothing and shower
necessities. Each youth will be issued a binder which they must keep up with and bring each day to the academy.
Monday-Thursday: 7:30 a.m. to 5:30 p.m. - Morning PT, classroom, hands- on and team-building skills will be
implemented. We expect every youth to participate to the best of their ability for the entire academy.
Friday: 7:30 a.m. to 5:30 p.m. - Morning PT, classroom and scenario training and final physical assessment.
**Graduation will be Monday June 17th, 2013 at 1730 hours (5:30 p.m.) at the FWPD Training Facility.
Please forward registration form with fees to:
Fort Worth Police Explorers
ATTN: Officer Rebecca Colwell
1000 Calvert Street
Fort Worth, TX 76107
If you have any questions please contact me at:
Email: Rebecca.colwell@fortworthtexas.gov
Office: (817) 871-6512 Fax: (817) 871-6521 Cell: (817) 944-7829
FORT WORTH POLICE DEPARTMENT
Explorer Annual Academy
June 10th-14th, 2013
REGISTRATION FORM
Applicant Name________________________________________ Date of application_________
Address______________________________________ City_________________ State_______
Zip___________ Contact phone number_________________________________
Contact Email______________________________________________________
Emergency Contact Person____________________________________________
Phone_______________________ Cell Phone_______________________
Email (Confirmations sent via email) _______________________________
Explorer Applicant Name
T-shirt size
Home
Male/Female
1. _____________________________________________________________________________
T-shirts:
Please list total number of each size t-shirt that you need. Each youth will be issued one explorer t-shirt to be worn
during the duration of class time. If you wish to order an additional shirt they will be $10.00 each for each additional
shirt.
SMALL
MEDIUM
LARGE
XLARGE
XXLARGE
XXXLARGE
TOTAL
#
New Explorer Registration Fee $25.00
New Explorer Academy Fee $ 25.00
Extra T-shirts $10.00
Total payment__________________________________
All check payments to be made out to FWPD Exploring.
Any questions please contact Officer Rebecca Colwell (817) 871-6512 or rebecca.colwell@fortworthgov.org
Mail to:
Fort Worth Police Academy
Attn: Rebecca Colwell
1000 Calvert Street
Fort Worth, TX 76107
Date Received____________
All Forms Complete_______________
What is needed ___________________
Payment Received_________________
Fax to: (817) 871-6521
Email to: rebecca.colwell@fortworthtexas.gov
FORT WORTH POLICE DEPARTMENT
Explorer Annual Academy
June 10th-14th, 2013
Statement of Consent and Limitation of Liability for
Explorer or youth participant
(Name) ________________________________________wishes to participate in the Explorer Annual Academy being offered as part of the Fort
Worth Police Department, Explorer Program. This academy will be held on (date) June 10th-14th, 2013 at (location) FWPD Training Academy,
located at 1000 Calvert St, Fort Worth, TX. Post Advisors/Fort Worth Officers will supervise this detail. The participants will be involved in
activities that will include running, jumping, sweating, yelling, staying out in the sunlight and other duties applicable to police scenarios and
having fun.
In consideration of the permission granted to me by the City of Fort Worth, Tarrant County, Texas and the Boy Scouts of America, Learning for
Life, to accompany, observe, and otherwise associate with Police Officers, civilian employees, agents or volunteers of the Fort Worth Police
Department as part of the Explorer Post Program, I, (We) hereby waive all claims for damages or loss to the above named person or property
which may be caused directly or indirectly by an act or omission of the City of Fort Worth, the Boy Scouts of America, Learning for Life,
TLEEAA, agents, employees or volunteers. I, (We) further release and forever discharge the City of Fort Worth, the Boy Scouts of America,
Learning for Life, TLEEAA, and the Fort Worth Police Department, their Officers, agents, employees or volunteers, whether real or asserted, of
every nature, kind and character whatsoever arising out of said Explorer Post Association and do hereby covenant not to sue.
Dated this
day of
, 20
.
__________________________________________
Signature of Explorer or youth Applicant
_________________________________
Signature of Guardian if under
eighteen or living at home
Medical Waiver
(Name of Applicant)
has my permission to participate in the program being offered by the Fort Worth Police
Department, Explorer Program. I know of no health or fitness restriction(s) that preclude his/her participation. In the event of illness or injury
occurring to my son/daughter while involved in this activity, I consent to X-Rays, examination, anesthesia, or medical or surgical diagnostic
procedures or treatment that may be considered necessary in the best judgment of the attending physician and performed by or under the
supervision of the medical staff of the Hospital or Clinic furnishing medical services. It is understood that in the event of a serious illness or
injury and I cannot be reached, I hereby grant the Fort Worth Police Department, its Officers, civilian employees or its volunteers, permission to
consent to necessary and appropriate medical treatment after all reasonable efforts to reach me have been attempted. (I), (We) do hereby agree
and indemnify and save harmless the City of Fort Worth and any City Representative or volunteer, from any claim by any person whomsoever or
account of such care and/or treatment of named participant. I agree that any bills as a result of this treatment are my responsibility to pay.
Dated this
day of
, 20
.
Guardian Signature
Explorer Signature___________________________________
In case of emergency I or some other family member can be contacted at these numbers:
___________________________________
Please list any medications or food allergies:
___________________________________
___________________________________
___________________________________
___________________________________