Camp Shoresh Leaders in Training (LIT) Application 2022
Please fill out this form to apply for the Leaders in Training (LIT) program. This form can be filled out by the youth applying, or by their guardian. Once you have completed this form, we will contact you to schedule a short interview with BOTH the youth and their guardian or parent to learn a bit about you and what you are hoping to get out of participating in the LIT program at Camp Shoresh.

Session 1: July 4-8 and July 11-15 (Cedarvale Ravine)
Session 2: July 25-29 and August 2-5 (Earl Bales)
Session 3: August 15-19 and 22-26 (Cedarvale)

Times:
9:00am – 3:30pm

Pricing:
$800 for a full two-week session. Subsidies are available through the Michelle Kopman Memorial Fund.

Thank you!
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Email *
PARTICIPANT INFORMATION
First Name *
Last Name *
Birthday *
Grade entering in Fall 2022 *
Which session are you applying for? *
Gender *
Required
GUARDIAN INFORMATION
Name *
Relationship *
Email *
Phone Number *
Address *
City *
Postal Code *
Is someone else approved to pick up the participant? *
If yes, please list their names here.  
Is the participant approved to leave at the end of the day on their own? *
EMERGENCY CONTACT INFORMATION
Please include the information of someone other than yourself that we may contact, in the event of a (G!d forbid) emergency, if we are unable to get a hold of you.
Emergency Contact Name *
Emergency Contact Phone *
Emergency Contact Relationship *
HEALTH AND WELLNESS
Does the participant have any allergies? *
If yes, please list here.  
Does the participant use an epipen or inhaler? *
If yes, please provide more information here.  
Is there any other information about the participants physical, mental, or emotional health that we should know in order to best support them?
GETTING TO KNOW YOU (the applicant) BETTER
What is your first language? *
What school do you attend? *
How do you identify Jewishly?
Does your family observe/practice/honour any religious or cultural traditions in addition to Judaism?  
Do you participate (or have you participated) in any other Jewish programs?
If yes, which one(s)?
Have you been to a Shoresh program in the past?
How did you hear about the LIT program at Camp Shoresh? *
If you were referred by someone, please let us know who!
SHORESH COVID PROTOCOLS
In order to ensure the health and safety of Shoresh participants, staff, and their families, we have put measures in place that are in line with the Canadian Federal Government, Public Health Agency of Canada (PHAC), and Health Canada's recommendations in light of the current COVID-19 situation. *
While participating in Camp Shoresh, participants are required to bring a clean mask and hand sanitizer.  When unable to maintain two metres (6 feet) from others, students and staff will be required to wear masks, covering both their mouth and nose.  Students should avoid touching their eyes, nose, or mouth as well as face masks.  Campers must avoid touching/sharing personal artifacts, including backpacks, water bottles, and activity materials.  You (parent/guardians) will be required to complete and submit a daily COVID-19 screening questionnaire when dropping off participants for the program.  Please note that masks, covering both your mouth and nose, are mandatory during drop-off.  Your children must be kept home if they are displaying any signs or symptoms of illness.  You must notify program leadership when your child is sick.  Please work with your healthcare provider should you or any member of your household demonstrate symptoms of COVID-19.  Should you or any member of your household test positive for COVID-19, or should you find out that you a known exposure to an individual who has tested positive for COVID-19, you must report this immediately to the program leadership.  Please note that washroom and handwashing facilities may not always be accessible during the Camp Shoresh.  
WAIVERS
Release and Waiver of Claims *
Please understand that we will take every measure possible to keep your child safe and to ensure that they will not be put in harm’s way.  By selecting "Yes, I accept this release and waiver of liability" below, I acknowledge that I have voluntarily enrolled my child in Camp Shoresh either at Cedarvale Ravine or Earl Bales Park. These locations are outdoor recreation spaces with hiking trails in forested areas. As such, insects, running water, exposed tree roots, prickly plants, and other such hazards inherent to outdoor forest activities exist in the space and may pose a danger to my child. I, by selecting "Yes, I accept this release and waiver of liability," on behalf of myself, and my child, hereby release and hold harmless Shoresh Jewish Environmental Programs and its officers, directors, employees and volunteers from any and all liabilities resulting from any injury my child may sustain in connection with and arising out of such hazards. I confirm that I have disclosed to Shoresh all relevant information which may be necessary or advisable to make Shoresh fully aware of any medical or other condition pertaining to my child, which may require special attention.
Photo Release *
We would love to take and share smiley photos of your children participating in our activities!  Photos and/or videos are used on Shoresh's website and social media platforms, as well as in Shoresh promotional materials.  Please note that names will not be published along with images.  
A copy of your responses will be emailed to the address you provided.
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