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Junior Law Enforcement Academy Application

  1. Adult T-Shirt Size

    Select T-shirt size

  2. **Relative(s) to notify in case of an emergeny if parent is unavailable

  3. I hereby waive and release any and all rights and claims for damages I may have against any and all individuals associated with the Lumpkin County Sheriff's Junior Law Enforcement Academy and the County of Lumpkin while my child attends the Lumpkin County Sheriff's Junior Law Enforcement Academy for any and all injuries suffered by him/her at said Academy. I attest and verify that my child is physically fit and able to attend the Lumpkin County Sheriff's Junior Law Enforcement Academy

  4. 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.

  5. 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.

  6. Leave This Blank:

  7. This field is not part of the form submission.