CPA Teen Academy Application

CPA Teen Academy Application

Please read the cover letter and fill out the application in its entirety.
Dear Parent and Student,

Thank you for inquiring about our Teen Police Academy! Our Teen Police Academy is a week-long and held this summer. Your youth will receive an in-depth look at the Cleburne Police Department and what it takes to be a police officer. Our goal is to instill leadership qualities in your youth while introducing them to the various aspects of Law Enforcement.

We will be utilizing many instructors from the police department as well as the SROs, Citizens On Patrol volunteers, and our Cleburne Police Cadets.

The dates for the Teen Police Academy are Monday, June 1 through Friday, June 5, 2026. Each day will begin at 8:30 a.m. and conclude at 4 p.m., with the exception of Friday. We will finish at 3 p.m. on Friday and have a short graduation ceremony at 5 p.m. Families are invited!

Attached to this letter is an application for the Teen Police Academy and some bullet points about the Academy. More information will follow if your youth is selected. Please assist your youth in going through this application and please fill it out together in its entirety. (Note: Failure to fill the application out fully may result in your application not being processed.)

Return the completed application to your Campus SRO (if a Cleburne ISD youth) or the Cleburne Police Department no later than Monday, May 4, 2026 by 5 p.m.

Please feel free to contact me with any questions or concerns that you may have. I can be reached at 817-556-8815. If I do not answer, leave a message with a callback number and I will call you back.

We hope for this to be a lasting experience for your youth.

Thank you for your time and attention,
Officer K.A. Abbott
Community Relations Officer / Teen Academy Coordinator
CLEBURNE POLICE DEPARTMENT • 302 W. HENDERSON ST. CLEBURNE, TEXAS 76033 • 817-645-0972

Quick Notes about the CPD Teen Police Academy
- Return the application no later than Monday, May 4, 2026 by 5 p.m.
- Academy dates are June 1 through June 5, 2026. The Academy begins each morning at 8:30 a.m. and ends promptly at 4 p.m. EXCEPT on Friday, which ends at 3 p.m. to prepare for the graduation at 5 p.m.
- The Academy will be held at the Booker T. Washington Recreation Center, located at 100 Mansfield Rd., Cleburne, TX 76031.
- Each cadet will be given an Academy T-shirt and photo ID. They must be worn each day, except on Friday during the day. We want everyone to wear their T-shirt for the graduation ceremony.
- Recruits must wear closed-toe shoes. No sandals or flip-flops are allowed.
- Your child must bring a refillable water bottle.
- Officers, cadets and civilian volunteers will be assisting with the Academy.
CLEBURNE POLICE DEPARTMENT • 302 W. HENDERSON ST. CLEBURNE, TEXAS 76033 • 817-645-0972

APPLICATION FORM

This is to be filled out by the APPLICANT, not parents or guardians.
CPD Teen Police Academy will be held Monday, June 1 through Friday, June 5, 2026.
APPLICANT NAME
Name

First NameMiddle InitialLast Name
Preferred Name
T-Shirt Size
Student's Date of Birth

MonthDayYear
Date
Gender
Race
School Name
Incoming Grade
Student's Home Address
Street
City
Zip Code
BEST METHOD OF COMMUNICATION WITH PARENTS
Phone
Format: (000) 000-0000.
Email
example@example.com
Parent or Legal Guardian Information
Mother's Name (Guardian #1)

First NameMiddle InitialLast Name
Date of Birth

MonthDayYear
Date
Driver License Number
Home Phone
Format: (000) 000-0000.
Cell Phone
Format: (000) 000-0000.
Other Number
(if applicable)
Please attached a photocopy of Guardian #1's driver license.

Cancelof
Father's Name (Guardian #2)

First NameMiddle InitialLast Name
Date of Birth

MonthDayYear
Date
Driver License Number
Home Phone
Format: (000) 000-0000.
Cell Phone
Format: (000) 000-0000.
Other Number
(if applicable)
Please attached a photocopy of Guardian #2's driver license.

Cancelof
OTHER EMERGENCY CONTACT PERSON
Name

First NameMiddle InitialLast Name
Street
City
Zip Code
Phone #1
Format: (000) 000-0000.
Phone #2
Format: (000) 000-0000.
PHYSICIAN INFORMATION
Name
Phone Number
Format: (000) 000-0000.

Applicant's Full Name
WAIVER, RELEASE AND HOLD HARMLESS
Parents or legal guardians must initial each of the below fields. Your signature at the bottom of this page indicates that you have read, understand, and agree to each of the following:
WAIVER OF LIABILITY
In consideration of the City of Cleburne and the Cleburne Police Department allowing the applicant to participate in the Cleburne Police Department Teen Academy (June 1-5, 2026), and being aware of the possible injuries that could occur as a result of that participation, I on behalf of myself and/or my minor child/children release the City of Cleburne, its officials, employees, Cleburne Police Department, officers, agents, instructors, volunteers, Cadets, from any and all claims of liability for death, personal injury, or property damage of any kind or nature whatsoever arising out of, or in the course of my participating in the program or in my use of City facilities. This will include travel to and from the program. I, my heirs and representative, agree to indemnify, save, and hold harmless the City of Cleburne, its officials, employees, Cleburne Police Department, officers, agents, instructors, volunteers, and Cadets, from any and all claims made by me and/or my child/children or my insurer for injuries or damages related to this event.
Initials for Waiver Liability:
RELEASE OF PHOTOGRAPHS AND LIKENESS
1. Grant the City of Cleburne permission to use my minor child's likeness, voice, photograph, and words in any form for promotional activities without payment or consideration.
2. Grant permission to use, edit, alter, or copy my minor child's photographs in any and all publications including Web sites without payment or any other compensation.
3. Grant the City of Cleburne all rights to release any photos taken of me or by me to the media.
Initials for Likeness Release:
MEDICAL RELEASE
I understand that in case of serious injury or illness, I will be notified as soon as possible. If it is impossible to reach me in a timely manner, I hereby give/grant my permission for emergency medical treatment as recommended by the attending physician for my minor child.
Initials for Medical Release:
MOCK WEAPONRY AND CSI RELEASE
During the course of instructions, the students will have the opportunity to utilize replicas or facsimile weapons. These mock weapons will be similar in size and weight to an actual weapon but, are completely inoperable and, incapable of firing a projectile.

During the course of instruction, the student may be exposed to real images of crime scene investigations that some might find disturbing. They will be used in an instructional manner with no intent to shock or harm anyone, they are designed to allow the student to understand the nature of Police work.
Initials for Weaponry/CSI Release:
ARRIVAL AND DEPARTURE FROM THE ACADEMY
I will ensure that my child will arrive every day, no earlier than 15 minutes before the start time, and will return to pick up my child no later than 15 minutes after the day of instruction has been completed. I will contact the class coordinator (contact information will be provided on the first day of class) if there are any delays. Failure to arrive on time, or be picked up at the correct time will be grounds for possible removal of the student from the academy.
Initials for Arrival/Departure Understanding:
PHYSICAL FITNESS
I certify that my minor child is of good physical condition and capable of mild physical activity. I have also listed below all physical conditions and medical conditions that may be pertinent:
Known medical conditions:
Initials for Medical Conditions:
OBSTACLE COURSE PERMISSION
Choose one. My child may or may not participate in the obstacle course.
Initials for Obstacle Course Choice:
Printed Applicant Name
Applicant Signature
Date

MonthDayYear
Date
Printed Name Parent/ Guardian
Parent Signature
Date

MonthDayYear
Date

Applicant's Full Name
NOTE: Unless all of your references are physically present and able to complete this online form with you, please print the application using the "print form" option at the bottom of this page (The answers you submitted so far will be saved in that PDF).

Once the references portion is completed, submit the completed application to the Cleburne Police Station (302 W. Henderson St.) or email the completed application to kerri.abbott@cleburne.net.
REFERENCES
A minimum of two references are required for each applicant that can attest to the student's behavior, overall demeanor, and suitability for the Teen Academy program. These references may be teachers, neighbors, or friends. NOT RELATIVES of the applicant's immediate family.
REFERENCE 1
Name
Relationship to Applicant
Do you believe the applicant would be a good candidate for the Teen Academy program?
Brief explanation of your answer:
Signature
Date

MonthDayYear
Date
Phone Number
Format: (000) 000-0000.
REFERENCE 2
Name
Relationship to Applicant
Do you believe the applicant would be a good candidate for the Teen Academy program?
Brief explanation of your answer:
Signature
Date

MonthDayYear
Date
Phone Number
Format: (000) 000-0000.
Applicant, please handwrite a short explanation of why you wish to attend the Cleburne Police Teen Academy.
Should be Empty:

CPA Teen Academy Application

Quick Notes about the CPD Teen Police Academy

APPLICATION FORM

APPLICANT NAME

BEST METHOD OF COMMUNICATION WITH PARENTS

OTHER EMERGENCY CONTACT PERSON

PHYSICIAN INFORMATION

WAIVER, RELEASE AND HOLD HARMLESS

REFERENCES