Leadership Training Leadership Development Camp Registration "*" indicates required fields Hey You're Registering! Good to See you Here!Thanks for sending in your application. Make sure you filled in all the blanks including clicking on the Captcha at the bottom of the form and are redirected to a confirmation page. *Please note: Registration is limited to 10 participants in grades 7 -12. Camp dates are Monday to Friday, July 8-12 from 9 am - 2 pm at Cedar Valley Church, 32860 Cherry Ave. Mission. Participant Name* First Last Date of Birth* DD slash MM slash YYYY Grade entering in September* School Attending in September* Gender*MaleFemalePrefer not to sayAddress* Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Student Phone (if applicable)Student's Email (provide parent/guardian's if you don't have one)* Enter Email Confirm Email Do you have any medical concerns or allergies?* Yes, I have medical concerns/allergies No, I do not If you answered yes to above, please describe your medical condition or allergic reaction and its severity.Church you attend (if any)* Parent/Guardian's Name* First Last Parent/Guardian's PhoneAlternate Parent/Guardian Emergency Phone*Parent/Guardian's Email* Enter Email Confirm Email Please explain why you want to be a student leader*Sometimes we use this information on our website or other promotional materials. We will ask you first!Please give a brief description of your experience in theatre arts, leadership or summer camps.*How did you hear about Jesters' Leadership Week?* I understand that as a Student Leadership participant that I am agreeing to help lead at one of the camps.*Please note that you can only choose one Camp to lead at as part of your Leadership Training but can register as a camper at the other camp for a reduced rate. Please check which you prefer to lead at. *Note: if are able to serve at either Camp, please check that box. Due to capacity limits, we can only have 5 Student Leaders onsite to lead at each Camp. If you want to participate in a camp as well, please note that registration is separate from the Student Leadership registration. The special rate of $50 for all student leaders is listed on the Summer Registration form. I prefer to lead at Super Incredible Acting Camp: July 15-19 I prefer to lead at Need for Thneed Musical Theatre Camp: July 29-Aug. 2 I can lead at either of the Camps. I understand that as a Student Leadership participant that I am agreeing to attend at least one of the fundraisers in addition to leading at one of the camps. I have checked my choice below.* Krispy Kreme Fundraiser: Sat., June 15 at Prospera Credit Union (Lougheed & Cedar) A July fundraiser (either another Krispy Kreme or volunteering at the Folk Festival) Details TBA I can attend both fundraisers; it's fun to hang out with friends! Any comments on camp or fundraiser availability?Count me in! I'm leading at the camp I checked above AND want to attend a camp and know that I have to also fill in a summer student registration to attend. NOTE: Those in grades 9-12 can attend both the Acting Intensive and camp they are not serving at if they want to*Each Participant in our Student Leadership Training Camp is required to serve at either Acting or Musical Theatre Camp and may attend the Acting Intensive (gr. 9-12 only) and/or the Camp not serving at I will/have fill(ed) out the Summer Theatre Registration form for the camp I want to attend I am not attending any other camps. Payment Options*Payment can be made early at the June 15 Krispy Kreme fundraiser, otherwise it is due at the first day of Camp accepted by cash, cheque, debit or credit card (a surcharge will be added for all credit card payments). $150 Registration Fee for Leadership Camp Please contact me for a reduced rate. If you would like a reduced fee, we're here to help! We have generous sponsors who help keep our registration fees low so money is never a barrier to being involved. Let us know any relevent information related to your situation and we'll be in touch.Appropriate health & safety protocols will be followed as per both GVYU policies and government health regulations.* Confirmation that I/my children will not come on-site if experiencing any symptoms of illness (coughing, sneezing, sore throat, aches etc.). Exceptions can be made for minor allergies on a case by case basis. Acknowledgment (Student)* I have read and understood everything on this form Acknowledgment (Parent)* I have read and understood everything on this form Jesters Theatre Photo and Video Waiver - I hereby grant Youth Unlimited permission to use my or my child's photograph and video in publications, displays, presentations and other related uses in any format (print and electronic):* Yes, I agree to the Photo and Video Waiver Today's Date* MM slash DD slash YYYY CAPTCHA