Police Youth Academy Registration Form
August 7th, 2023 through August 11th, 2023

Township of Hamilton Police Department
6101 Thirteenth Street
Mays Landing, NJ 08330

Program Coordinator: Ofc. Dennis Bakker

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Participant First Name: *
Participant Last Name: *
Participant Date of Birth *
Participant Age at Time of the Youth Week *
Please indicate the age the child will be while participating in the Youth Week. 
School Name: *
Grade This Coming Fall:
Home Address: Home Number and Street *
ie.    123 Academy Avenue
Home Address: City/Town *
Home Address: Zip Code *
Home Phone Number: *
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