2020 Leaders in Training Application

First Name *

Last Name *

Please Enter Date of Birth *

Year

Month

Day

Email Address *

Cell Phone Number (if Applicable)

Grade entering in September 2020 *

Name of School Attending *

T-shirt Size *

Adult Small

Adult Medium

Adult Large

Adult Extra-Large

Uniform t-shirts are provided to you, please indicate your unisex T-Shirt size

Street Address *

City *

Postal Code *

Parent/ Guardian Name *

Parent/Guardian Home Phone number *

Parent/ Guardian Cell Phone number *

Parent/Guardian email address *

Emergency Contact Name *

Emergency Contact phone number *

Health card number *

0000-000-000-XX

Allergies or medical conditions *

Do you have an Epi pen? *

Yes

No

Additional Information

Is there any additional information we should know about?

Dietary restrictions

Please indicate any food allergies or restrictions (i.e. vegetarian, vegan, halal)

What does being a leader mean to you? *

What experience/ qualities do you possess that will make you a positive role model for the campers and a responsible Leader in training? *

Please provide an example

What do you like to do in your spare time? *

List any extracurricular activities, hobbies, clubs, teams etc.

Please list any relevant volunteering experience *

Please indicate which month(s) you can volunteer *

Commitments must be for a 4 week period, all placements are Monday- Friday, 8:30am-4:30pm

Month 1 (Monday, June 29 to Friday, July 24, 2020)

Month 2 (Monday, July 27 to Friday, August 21, 2020)

Are you interested in being a bus monitor? *

(bussing for monitors is free - limited number of bus monitors accepted) Bus monitors are responsible for the children before the morning bus pick-up, during the bus ride, and after the bus drop-off We have a bus in Mississauga, Oakville and Burlington

No I do not want to be a bus monitor

Yes- I would like to monitor the Mississauga Bus (1 stop: John Fraser Secondary)

Yes- I would like to monitor the Oakville Bus (1 stop: Glen Abbey Rec Centre)

Yes- I would like to monitor the Burlington Bus (2 stops: Mainway Rec & Central Library)

Will you require bussing from one of our bus stops? *

If you are not interested in being a designated bus monitor or you are not accepted as a bus monitor but you will require bussing from one of our bussing locations, please indicate that below. The standard bussing fee is $75/week

No I will not require bussing from one of Venture's Buses/ Stops

Yes- I will require bussing from the Mississauga Bus (John Fraser Secondary)

Yes- I will require bussing from the Oakville Bus (Glen Abbey rec)

Yes- I will require bussing from the Burlington Bus at stop: Mainway Rec centre

Yes- I will require bussing from the Burlington Bus at stop: Central Library

Indicate the section of camp you would prefer to volunteer with *

Choose all that apply. Please note that preferences are not guaranteed

Engineering Science

Engineering Technology

Codemakers

Lab technician

Do you have any coding experience? *

please indicate what experience you have with coding (online coding activities, school classes, camp, etc...)

Which age groups would you prefer to volunteer with? *

Please note that preferences are not guaranteed

Grades K-4

Grades 5-7

Have you attended Venture as a Camper before? *

Yes

No

Have you completed a placement as a Venture JC/ Leader in Training before? *

No

Yes

If you were a JC/Leader in Training in the past please indicate when

what year were you a JC

Consent, Waiver, Indemnity & Release Form Photographs, Video and Voice Recording *

If the participant is under the age of 18, a Parent or Guardian must read and submit This document relates to the Junior Counsellor Leadership Program scheduled to occur on June 21, 2019. Permission. I, the undersigned, hereby grant permission to McMaster University (“McMaster”) and its representatives to photograph and video me, and otherwise capture my image, and to make recordings of my voice at the event or location referenced above. McMaster Rights. I hereby grant to McMaster and its representatives, the right to use, reproduce, distribute, and broadcast my image, including my name, voice, likeness and affiliation with McMaster captured in such recordings in any media now known or later developed as well as my name for promoting, publicizing or explaining McMaster and its activities and for administrative, educational or research purposes. This right also extends to any of the contents performed, created or provided by me which are captured in any recordings, such as my performances, artwork, compositions or similar materials (the “Materials”). This right is irrevocable, royalty-free, worldwide, non-exclusive and transferable. Ownership. I acknowledge that McMaster owns all rights to the images and recordings. Waiver. I hereby waive: any right to inspect or approve the use of the images or recordings or of any written copy; all moral rights; and any right to royalties or other compensation arising from or related to the use of the images, recordings or materials. Indemnity. I hereby release, defend, indemnify and hold harmless McMaster, its Board of Governors, officers, employees or agents from and against any and all claims, damages or liability arising from or related to the use of the images, recordings or materials, including but not limited to claims of defamation, invasion of privacy or rights of publicity or copyright infringement, or any misuse, distortion, blurring, alteration, optical illusion or use in composite form that may occur or be produced in taking, processing, reduction or production of the finished product, its publication or distribution.

Candidate Questionaire

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