YOUTH LEADERSHIP APPLICATION 2016 Application must be filled out by applicant (Please legibly print or type)

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Victoria Bates
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1 YOUTH LEADERSHIP APPLICATION 2016 *Application must be filled out by applicant* (Please legibly print or type) APPLICATION DEADLINE: Tuesday, April 05, 2016 Program Fee: $165 due by May 20, 2016 The Apprentice Program (entering 8 th or 9 th grade) is designed to give youth an experience to learn leadership skills and responsibility. The CIT Program (entering 10 th grade or higher) gives youth the opportunity to use and expand their leadership skills by leading games and activities. Position applying for: Apprentice CIT Are you NEW or RETURNING to the Youth Leadership Program? (circle) If new, how did you learn about the Youth Leadership Program? PERSONAL INFORMATION Name: Address: Home Phone #: Youth Leader Cell Phone #: Date of Birth: / / T-shirt Size: (adult sizes: S, M, L, XL, XXL) Age: Grade in Fall 2015: College (circle) School Attending: Youth Leader Address*: *Note: The majority of correspondence regarding this program will be via . Parent Name: Daytime Phone #: Parent Address*: *Note: The majority of correspondence regarding this program will be via .

2 A. Why are you interested in being a Youth Leader this summer? What do you hope to gain from participating in the Youth Leadership Program? B. As a Youth Leader, the campers will look up to you and your actions. How will you be a positive role model and mentor to the campers? C. Give an example of how you will provide an excellent summer experience to campers and their parents. D. Rank your preference of interview dates and times: (1=1 st choice, 2=2 nd choice, 3=3 rd choice) Interviews will be held at the Pleasant Valley Recreation Center (2320 North Avenue, next to Bidwell Jr. High School) Friday, April 29 th (4:00-5:30 pm) Saturday, April 30 th (9:30-11:00 am) Saturday, April 30 th (11:15am-12:45pm) E. Participation in the Youth Leadership Program includes attendance at the mandatory training. Depending on the camp weeks selected, you will be scheduled for one of the following sessions. If you are selecting camp weeks that take place in the first half of the summer, expect to attend the first training. You will not start volunteering at summer camp without attending training first. The training you are expected to attend will be confirmed when your summer camp schedule is sent to you. Please check that you are available for one or both sessions: Training will be held at the Pleasant Valley Recreation Center (2320 North Avenue, next to Bidwell Jr. High School) Saturday, June 11 th (9:30 am-2:00 pm) Saturday, July 9 th (9:30-2:00)

3 F. Have you ever been convicted of a criminal offense (felony or serious misdemeanor)? (Convictions for marijuana-related offenses that are more than two years old need not be listed.) If yes, state nature of the crime(s), when and where convicted and disposition of the case. (Note: No applicant will be denied admission to the Youth Leadership Educational Program solely on the grounds of conviction of a criminal offense. The nature of the offense, the date of the offense, the surrounding circumstances and the relevance of the offense to the position(s) applied for may, however, be considered.) SIGNATURE REQUIRED CERTIFICATION OF APPLICANT: By signing below, you acknowledge the following: By participating in the Youth Leadership Educational Program, you are a volunteer and not an employee of CARD. By participating in the Youth Leadership Educational Program, you are not entitled to a job with CARD at the conclusion of the training period. By participating in the Youth Leadership Educational Program, you are not entitled to wages or any employee benefits for the time spent in training. CERTIFICATION OF PARENT/GUARDIAN: By signing below, you acknowledge the following: I agree to attend the parent information meeting held at the CARD office on Tuesday, April 19 th at 6:00 pm. I understand that failure to attend this meeting disqualifies my child/applicant from the Youth Leadership Program. (PLEASE CHECK BOX) Signature of Applicant Date: If under 18, signature of Parent or Legal Guardian must also be provided Date:

4 APPRENTICE PROGRAM (Entering 8 th or 9 th grade) Camp Chi-Da-Ca (Papoose weeks) Hours: 7:15 am - 12:15 pm M-F, June 6-10 M-F, June M-F, July M-F, June T-F, July 5-8 M-F, August 1-5 M-F, July 5-8 M-F, July My First Camp Hours: 8:00 am 12:45 pm Only Choice M-F, June M-F, July ShortE All Stars Sports Camp for 3-5 Years of Age Hours: 7:30 am - 12:15 pm Choice A M-F, June M-F, June 27-July 1 M-F, July M-F, August 1-5 Choice B- Misc. Camps M-F, June (Little Hoopsters) M-F, July (Little Hoopsters) M-F, August 8-12 (Little Hoopsters) Choice C-Misc. Camps T-F, July 5-8 (Little Tykes Flag Football) M-F, July (Little Kickers) NEW! Camp Chico Creek for 5-11 Years of Age Hours: 8:45am-4:15pm M-F, June T-F, July 5-8 M-F, July M-F, June M-F, July M-F, August 1-5 M-F, June 27-July 1 M-F, July M-F, August 8-12

5 CIT PROGRAM (Entering 10 th grade or higher) Summertime Delight Hours: 9:00 am - 2:30 pm M-F, June T-F, July 5-8 M-F, July M-F, June M-F, July M-F, August 1-5 M-F, June 27-July 1 M-F, July M-F, August 8-12 Camp Chi-Da-Ca (Indian weeks) Hours: 9:15 am - 4:30 pm M-F, June M-F, June 27-July 1 M-F, July M-F, June 27-July 1 M-F, July M-F, August 8-12 M-F, July M-F July Sports Camp for 3 rd -7 th Grade Hours: 7:30-5:30 or 7:30-12:30 Choice A- Flag Football Choice B- Volleyball M-F, June M-F, June 6-10 (returning CIT s only) M-F, July M-F, July M-W, August Choice C- Basketball M-F, June M-F, August 1-5 Choice D- Misc. Camps M-F, June 27-July 1 (Baseball) T-F, July 5-8 (Olympics) Choice E-Soccer Choice F-Misc. Camps (8:00-12:45) M-F, July M-F, June (A Bug s Life) M-F, August 8-12 M-F, July (Camp out with CARD M-F, August 1-5 (Kinder Readiness) M-F, August 8-12 (A Bug s Life) NEW! Camp Chico Creek for ages 5-11 years old Hours: 8:15-4:15 M-F, June T-F, July 5-8 M-F, July M-F, June M-F, July M-F, August 1-5 M-F, June 27-July 1 M-F, July M-F, August 8-12 ***Please see other side for additional camps***

6 Garden Camp Hours: 8:30-12:00 Only Option M-F, June 6-10 M-F June 27-July 1 (Kitchen Science, Hours are 1:00-5:00) M-F July American Doll Camp Hours: 8:00-1:00 (hours may vary) Only Option M-F, July 11-15

First Name Last Name. Street Address. City/State/Zip Code. Home Phone Cell Phone. Date of Birth Social Security # School Name Grade

First Name Last Name. Street Address. City/State/Zip Code. Home Phone Cell Phone. Date of Birth Social Security # School Name Grade Teen Summer Camp Volunteer Program Job Description Teen Summer Camp Volunteer Program Teen Camp Counselor Application Date First Name Last Name Street Address City/State/Zip Code Home Phone Cell Phone