CAMP ELMWOOD’S

TEEN LEADERSHIP PROGRAM

For Young People Ages Thirteen to Eighteen

Monday through Friday, August 6-10, 13-17, 2012

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Under the Redwoods on the Grounds of St. John's Presbyterian Church,

2727 College Avenue, Berkeley, 94705

Schedule: 9:00 AM to 3:00 PM Monday through Friday; until 9:00 PM Friday August 17 for closing barbeque and program

Teen Leadership Camp for teens only is August 6-10. This will be a week of training and practice for leadership in life and in camp activities including volley ball, basket ball, ping pong, skate boarding, gymnastics, lawn games, cooking, art, music, drama, dance, swim-hike, science, community service, and other activities suggested by our participants. We will also be preparing to lead our campers in exploring our theme for this year: Honesty: What is it? Is honesty always the best policy? Why should we be honest? Are there any times we should be dishonest?  Our exploration will be through shared ideas, improv, role play, art, drama, music, and stories of honest and dishonest people. Our week will include a one day beach trip including a chance to try surfing.

 
Camp Elmwood  for campers ages 5-13 and teen counselors ages 13-18 is August 13-17. Everyone who successfully completes Teen Leadership Camp August 6-10 and demonstrates the ability to play a positive role in our camp will be invited to be a teen counselor for Camp Elmwood.

 
Cost: Teen Leadership Camp August 6-10 is free. Teen Counselors at Camp Elmwood August 13-17 will receive an honorarium of $50.00 in appreciation of their help plus $10.00 additional for each year of prior service. Everyone brings her/his lunch.

 
Applications: Space is limited. Please complete and return registration application as soon as possible. Persons new to our program should also submit a recommendation form.  For more information, applications, and recommendation forms call (510) 845-6830 extension 13 or go to http://www.stjohnsberkeley.org.

 Camp Elmwood is community service program of St. John's Presbyterian Church, Berkeley, emphasizing creativity, values, and concern for others. This is our nineteenth year.

 

KIDS TOGETHER, HAVING FUN, SHARING SKILLS,

HELPING OTHERS

Download complete pdf version of application here

CAMP ELMWOOD TEEN LEADERSHIP PROGRAM APPLICATION

August 6-10, 13-17

Must be completed in applicant’s own handwriting.

 

Name_____________________________________________ Birth Date and Year___________

 

Address_______________________________________________________________________

 

City______________________________________________________ Zip_________________

 

Telephone (home)_________________________ (cel) ________________________________

 

email________________________________________________________________________

 

School________________________________________ Entering Grade (Fall 2011)_________

 

Favorite school subjects__________________________________________________________

 

Musical instruments played_______________________________________________________

 

Areas of special interest and participation (teams, music and art lessons, hobbies, youth groups)

 

_________________________________________________________________________________

 

_______________________________________________________________________________

 

References (name, address, and telephone of two adults, at least one of whom has worked with you

 

as coach, teacher, or activity leader)_______________________________________________

 

_______________________________________________________________________________

 

Do not submit this application until you have carefully read and written “YES” as your response to each certification and promise on the back of this form.

 

Completed parent or guardian permission slip must be submitted with this application.

 

If you are new to Camp Elmwood, a completed recommendation form must also be submitted.

 

 Return all forms to Camp Elmwood, 2727 College Avenue, Berkeley CA 94705.

 

 

 

 

 

 

 

 

CAMP ELMWOOD TEEN LEADERSHIP PROGRAM

CERTIFICATIONS AND PROMISES

August 6-10, 13-17

 

After reading carefully, please write “YES” in your own handwriting (check marks are not acceptable) in each space below to confirm that you have read and understand each promise and representation you are making as part of this application.

 

I certify that I have a good record of school attendance and participation.          ______

 

I do not use tobacco, alcohol, or illegal drugs.                                        ______

 

If selected I will participate fully in the entire camp from 9:00 AM to 3:00 PM Monday through Friday and until 9:00 PM Friday August 17 unless excused for illness or required school registration.                                                              ______

                  

I will NOT leave the camp without the permission of the director.                 ______

 

I will at all times be courteous and respectful toward camp leaders, my fellow teen counselors, and all the campers.                                                                         _____

 

I will NOT use vulgar or abusive language at any time during camp.           _____

 

I will NOT use a cell phone, i-pod, or other electronic equipment at any time from the time camp begins until camp ends each day except when authorized for a particular activity                                                                                                         _____

 

I understand that to participate as a teen counselor at Camp Elmwood August 13-17 and receive my honorarium I must successfully complete Teen Leadership Camp August 6-10 and show that I can play a positive role in the camp.           _____

 

I am submitting this application because I want to learn, to participate, to help others, and to have fun. I am not submitting this application just to please my parents or any other adult.                                                                                                 ______

 

I have personally completed this application.                                        ______

 

 

Date____________Signature______________________________________________

 

 

 

 

 

CAMP ELMWOOD’S TEEN LEADERSHIP PROGRAM

August 6-10, 13-17, 2012

PARENT/GUARDIAN PERMISSION

 

Name of Applicant______________________________________________________

 

I certify that I am the parent or guardian of the applicant.

 

I have read the application being submitted by the applicant and will support the applicant in fulfilling the promises and commitments made. I know of no reason why the applicant will not be able to participate fully from 9:00 AM to 3:00 PM Monday through Friday and until 9:00 PM Friday August 17 for closing barbeque and program.

 

Except as noted below, the applicant is fully able and has my permission to participate in all normal camp activities and excursions. Members of Camp Elmwood staff have my permission to authorize emergency medical treatment for the applicant. I will pay any cost of treatment not covered by my insurance.

 

______ Applicant may participate in skateboarding, I will provide helmet.

 

Special needs or activity restrictions________________________________________

 

_____________________________________________________________________

 

Health insurance program and number______________________________________

 

____________________________________________________________________

 

Parent or guardian name_________________________________________________

 

Address______________________________________________________________

 

City_________________________________________________ Zip____________

 

Telephone (home)_____________(work)_______________(cel)_______________ 

 

Email______________________________________________________________

 

Emergency contact (name and phones)______________________________________

 

____________________________________________________________________

 

Date______________Signature___________________________________________