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Disclaimer


The Port St Lucie Police Department welcomes the opportunity to work with families in our community, especially those with underprivileged children who may not have the same as others their age. Shop with a Cop is one of the ways we strive to strengthen our opportunities community and reach out to these families. Our Department’s endeavor is to make this a positive experience for the children. In partnership with Wal-Mart and Target, children in need are able to purchase gifts for Christmas, including ones for themselves as well as other family members.

Criteria

  • Child is between 5 and 18 years old (must still be in high school)
  • Family resides in Port St Lucie (Must provide recent copy of utility bill and photo id)
  • Child must be able to separate from families while shopping
  • Child must be present on the shopping day in order to apply
  • Participant’s parent/guardian must provide transportation

A committee will make selections from the applications based on information received through applications. Families who have not participated before will be given priority, however all applications will be given serious consideration. Given the popularity of the program, we may have more applicants than openings. Completing an application DOES NOT guarantee participation in the program.

Parent Information


Fields marked with * are required to submit application.


Child(ren) Information


Photo/Media Consent


By signing below you consent to the name, portrait, photograph, videotape, or other likeness of all minors in the above section, taken at a Port St Lucie Police Department event to be used for the purpose of promoting the department and its events.

Emergency Contact Information


Release of Liability


I agree for myself and (if applicable) for the members of my family that, in exchange for participation in the following activity of: Shop with a Cop

This event has been organized by the Port St Lucie Police Department (PSLPD)

To the Following

I agree to obey and observe any and all posted warnings and rules, and agree to follow any directions or oral instructions given by the PSLPD, or the representatives, employees or agents of the PSLPD.
I understand that my and my family members hereby expressly and specifically assume the risk of injury orharm in these activities and release the PSLPD, its officers, employees and agents from any and all liability for injury, illness, loss, death or property damage resulting from the activities of me or my families partcipation in Shop with a Cop.
I agree to indemnify and hold harmless the PSLPD, its affiliates, and its respective officers, directors, agents and employees from an and all claims, demands, losses, causes of action, damage, lawsuits, judgments, including attorneys' fees and costs, arising out of my or my family's use, participation or presence upon the facilities of the PSLPD or participation with the Shop with a Cop program.
Any equitable or legal claim or claims that may arise from the participation in the above shall be resolved under the laws of the State of Florida.

The name of the person signing the release on behalf of the minor child: