Community Camera Program

• Name*
  First Last
• Business Name
• Address*
  Street Address City State ZIP / Postal Code
• Email*
• Phone Number*
• Number of Cameras*
• Select all that apply
  • Front Yard
  • Back Yard
  • Driveway
  • Alley
  • Front Door
  • Back Door
  • North Side of Property
  • East Side of Property
  • South Side of Property
  • West Side of Property
  • Patio
  • Lobby
  • Hallway
  • Room/Office
  • Other
• Please check the box below after reading the acknowledgement at the bottom of the page.*
  I have read and understand the acknowledgement.
• Electronic Signature*
• Date*
  Month

  Day

  Year
• Comments
  This field is for validation purposes and should be left unchanged.

Acknowledgement

If necessary, the Washington Police Department will contact you directly, using the information provided by you at the time of registration, to request the appropriate video surveillance footage.  Any and all video surveillance footage shall remain the property of the registrant until it is requested by the Washington Police Department and collected from the registrant by the Washington Police Department.  Your voluntary participation in this program shall not be construed as an obligation to release any surveillance video to the Washington Police Department upon request. Any footage containing or related to criminal activity collected by the Washington Police Department may be used as evidence during any stage of a criminal proceeding.

Under no circumstances shall registrants construe that they are acting as an agent and/or employee of the City of Washington and/or the Washington Police Department through the program. Under no circumstances shall the Washington Police Department utilize any information obtained to view the footage/feeds directly from cameras owned by registrants.

*indicates a required field