Crossroads re-Imagined Youth Camp 2022 Application Form

Crossroads re-Imagined Youth Camp 2022: Application Form
DATES: 15th July – 24th July 2022
LOCATION: Kampos, Nicosia

Complete all elements of the application form and send with a scanned copy of the signed consent of a parent/ guardian (Part III), to ahdr@ahdr.info.

The application deadline is 1st June 2022.

IMPORTANT INFORMATION:

● Participation age range: 14 - 17 years old
● Participants must be legally able to cross at checkpoints
● Participation fee (payable only after the selection of participants):
- Earlybird: 25 Euros (apply by 29 April and pay by 15 June if successful)
  *OR*
- Standard: 35 Euros (apply by 1 June and pay by 30 June if successful)
Successful applicants will be contacted after the deadline in order to process payments.

For more information, please contact us:
● Tel: (+357) 99790848 / (+90) 533 853 7470
● Email: ahdr@ahdr.info
Description of the camp

Crossroads re-Imagined Camp takes place from Friday 15th July until Sunday 24th July 2022 at the village of Kampos in the district of Nicosia. It is implemented by the Association of Historical Dialogue and Research (AHDR) and funded by the Federal Foreign Office of Germany.

Crossroads re-Imagined Camp is designed for young people aged 14 - 17 years old and it aims to support the contact and cooperation between young people from all the communities in Cyprus by building mutual respect for each other, breaking down stereotypes and promoting reconciliation in the framework of a Culture of Peace and Non-Violence.

The camp’s core activities are designed and implemented by skilled and experienced educators, facilitators and visiting artists, based on a range of expressive arts and applied theatre approaches, peace education methodologies and non-formal education tools. Activities at camp include workshops on a variety of topics with the purpose of promoting meaningful communication and providing safe spaces for creative learning, democratic dialogue and mutual understanding and respect between young people. Crossroads re-Imagined Camp always concludes with a final piece of work developed by the young people and shared with family and friends, showcasing the 10-day long learning journey participants experienced together.

Crossroads re-Imagined Camp returns in 2022, with the recognition that safety and health should be a primary concern. For the protection of everyone involved, we have prepared a health protocol, which will be regularly updated, with full information about the precautions that will be taken. The CDC guidelines will be followed and all necessary measures will be taken to ensure safe participation of all in the camp activities.
1. PERSONAL INFORMATION
Participant Name*

First NameLast Name
Birth Date*

MonthDayYear
Date
Gender*
Place of Birth*
Citizenship*
ID/ Passport Number*
Home Address*

Street Address

Street Address Line 2

CityProvince

Postal / Zip Code
Phone Number*

Country CodePhone Number
Email*
example@example.com
School and Class/ Year*
2. ADDITIONAL INFORMATION
What do you do in your free time? What are your interests? *
Have you ever been a member of a group/ team? What does being part of a group mean to you?*
Have you taken part in a youth camp before? If so, how was the experience for you?*
Have you ever participated in any bi-communal activities before?*

No, I have not participated in any bi-communal activityYes, I have participated in a bi-communal activity
If yes, please indicate the activity/ activities you have participated in:

Crossroads / Crossroads re-Imagined CampCyprus Friendship ProgramImagineJunior Achievement Cyprus Innovation CampPeacePlayers Basketball CampOther
Tell us a bit about what remember the most from it/them
What are your expectations from Crossroads re-Imagined camp?*
Describe yourself in three words: *
Level of English Language*

1

2

3

4

1 is Poor, 4 is Excellent
Mother Tongue*
Other languages (please specify and explain your level of competency)
3. Health Information (to be completed with Parent/Guardian)

This information will be kept confidential and will only be used for the purpose of supporting the participant’s needs, should s/he be selected for participating in the camp.
Medical issues (please specify if the applicant has any medical conditions that the camp staff and facilitators should know about (e.g. Asthma, Diabetes, Anxiety etc.) )*
Medications & Supplements (please list any medications or food supplements the applicant is currently taking)*
Allergies (please describe any allergies to food, medication, animals, or substances and any usual relevant symptoms)*
Dietary Needs (e.g. vegetarian, vegan, gluten free etc.) *
4. Person to contact in case of a medical or other emergency
Emergency Contact's Name*

First NameLast Name
Relation to applicant*
Mobile Number*

Country CodePhone Number
Alternative Phone Number

Country CodePhone Number
Parent/ Guardian Consent Form

● I confirm that I am informed about the content of Crossroads re-Imagined Camp, which will take place at the village of Kampos from 15 to 24th of July 2022.

● I confirm that I have read and give full consent for the health and safety protocol.

● I understand there is a 35 EUR fee (25 EUR for Earlybirds) which must be paid by cash or bank transfer after 1 June if this application is successful.

Please use this letter template and sign it, then attach to this form stating your consent.

You can print the letter and sign it by hand and then take a photo/scan and upload here. OR you can download the letter and sign it electronically and then save it and upload here.
Please attach the parent/ guardian consent form.*

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Crossroads re-Imagined Youth Camp 2022: Application Form