2019 Summer Camp - July 22nd to 29th

2022 Summer Camp - July 18th to 22nd

Leader-In-Training (LIT) Application Form
This form is for Leaders in Training from Grades 7 through 12 (Fall 2022).
To be completed by applicant...
Name*

First NameLast Name
Date of Birth*

MonthDayYear
Name of school you attend
School Name
Do you have a friend applying for LIT?
Name
Please answer the following questions in your own words.
(There are no right or wrong answers – we just want to know more about you)
Share any experience, skills or talents that you have that would help you in working with children at camp.
What areas of camp would you like to serve in and why? (e.g. indoor and outdoor games, team building activities, bible-based explorations, arts and crafts, dance and drama, nature activities, storytelling and music)
What values do you feel are important for children to learn?
To be completed by parent...
How did you hear about Burns camp?
Parent or Guardian Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Phone #

Area CodePhone Number
Cell Phone #

Area CodePhone Number
E-mail Address*
Emergency Contact Name*

First NameLast Name
Emergency Contact Phone #*

Area CodePhone Number
Health Concerns/Allergies
What will make your child’s stay with us most enjoyable? Are there any food allergies, medications, physical disabilities or learning disabilities of which we should be aware? Please note this information will be kept confidential and will only be used to facilitate your child’s comfort in our programs.
Additional Information
I give full permission to Burns Presbyterian Church to use my child’s photograph, still or video, in connection with their activities and I consent to use of such material or its reproduction in any manner and by any medium which Burns Presbyterian Church, at their sole discretion, deems appropriate.I am aware and give my permission for my children named in this registration to participate in Burns Camp activities off church property, at Ashburn Community Centre (across the street from the church) and Ashburn Park (taking a short trail walk that begins behind the Community Centre).
I AGREE (Parent/Guardian)

First NameLast Name
Date

YearMonthDay
Please enter the word(s) shown in the image:*
Should be Empty:

2022 Summer Camp - July 18th to 22nd