PAL Mentoring
Everybody needs APAL: Mentoring is a free program aimed to engage youth and make a connection with their communities and law enforcement and to help further their life skills and values.
Childs Name *
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Date of Birth *
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Age *
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Sex: *
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Home Address *
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Telephone *
Your answer
School *
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Grade *
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Parent/ Guardian Name *
Your answer
Relationship to applicant *
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Email *
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Phone (Home/Cell)
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Phone (Work)
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Emergency Contact Name *
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Emergency Contact Phone (Home/Cell) *
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Are you an Albany Public Housing or Section 8 Benefactor?
Female head of household?
Does your child qualify for the free or reduced lunch program?
Racial Group(s): Please select any/all of the following that apply to the applicant.
Hospitalization plan *
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Policy # *
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Allergies *
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Doctor *
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Doctors Telephone *
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I/WE, the Parents or guardians of the above named candidate for a position on the Albany Police Athletic League Inc. (PAL), hereby give my/our approval for our child to participate in any and all PAL activities. I/we know that participation in PAL activities may result in serious injury, and that protective equipment does not prevent all injuries to players and/or participants, and I/we do hereby waive, release, absolve, indemnify and agree to hold harmless the Albany Police Athletic League, PAL Board members, National PAL, organizers, sponsors, supervisors, participants and persons transporting my/our child to and from activities from any claim arising out of any injury to my/our child whether the result of negligence or any other cause. I/we do hereby give permission for my child to receive medical treatment in case of an emergency if I/we cannot be contacted. I/We do hereby give permission for my/our child’s photo likeness to be used in any and all PAL promotional literature. Parent/Guardian Signature: *
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