Project Guardian - Annual Renewal | Yakima Police Department

Project Guardian Annual Renewal…

Renewal

Renewal is easy. Caregivers can update the information of family members who are already enrolled in the program.

This program only covers the patrol area of the Yakima Police Department. Contact Sgt. Ryan Yates (ryan.yates@yakimawa.gov) if you have any questions.

Registrant Information
Registrant Name*
First Middle Last Suffix
Date of Birth*
Month
Day
Year
Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Race
Sex
Height
Weight
Hair Color
Eye Color
Photo Upload
Accepted file types: jpg, png, gif, jpeg, Max. file size: 15 MB.
Upload a recent photo of the registrant. Only jpg, gif, or png files allowed.
Caregiver Information
Caregiver Name
First Middle Last Suffix
Relationship to Registrant
Date of Birth
Month
Day
Year
Address
Street Address Address Line 2 City State ZIP Code
Phone 1
Phone 2
Phone 3
E-Mail Address
Race
Sex
Height
Weight
Hair Color
Eye Color
Alternate Caregiver Information
Alternate Caregiver Name
First Middle Last Suffix
Relationship to Registrant
Date of Birth
Month
Day
Year
Address
Street Address Address Line 2 City State ZIP Code
Phone 1
Phone 2
Phone 3
E-Mail Address
Race
Sex
Height
Weight
Hair Color
Eye Color
Registrant Details
Diagnosis
What are his/her favorite toys, objects, music, discussion topics, likes, dislikes?
How does he/she communicate? Is he/she verbal or non-verbal?
What types of behaviors should be expected? (Kicking, hitting, biting, spitting, self-harm, body rocking, hand flapping, self-talk)
What is the best way to approach him/her?
Does he/she have any trigger or sensitivities? (Lights, sirens, loud radio noise)
If he/she becomes confrontational, how can officers calm him/her?
What works best to reduce stress or calm him/her?
Detail any information you think would be important for officers to know:
If he/she gets upset and runs away, where might they go?
Does he/she have any devices that could track their location, if lost?
I, the undersigned, for myself and the registrant named above do hereby authorize the Yakima Police Department to release the aforementioned information in response to Emergency Calls (to include Missing Persons incidents) regarding the registrant and do further agree to indemnify and hold harmless the Yakima Police Department and persons (placed) associated with it.*

Print name of Caregiver/Responsible Party
By checking this box and typing my name below, I am electronically signing my renewal*
- I agree
Signature*

Signature of Caregiver/Responsible Party
Phone
This field is for validation purposes and should be left unchanged.

Community Services

Project Guardian Annual Renewal…

Renewal

Registrant Information

Caregiver Information

Alternate Caregiver Information

Registrant Details

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