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Summer 2020 LIT Program Application
Personal Information. (All information will be kept confidential, and used only by Camp Medley personnel)
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* Indicates required question
Last Name:
*
Your answer
First Name:
*
Your answer
Gender:
*
Male
Female
Other
Street Address:
*
Your answer
City:
*
Your answer
Province:
*
Your answer
Postal Code
*
Your answer
Contact Email:
*
Your answer
Contact Home Phone:
Your answer
Contact Cell Phone Number:
*
Your answer
How many years have you been a camper at Camp Medley? (Or other camps)
Your answer
Tell us a little bit about yourself - who you are, interests, etc..
*
Your answer
Please check the activities you feel confident to being involved with
Archery
Nature Program
Outdoor Living
Swimming
Arts & Crafts
Canoeing
Drama
Bible Study
Sports
Other:
Please provide current and applicable Certifications:
Please provide applicable certifications (i.e. CPR, Canoeing, Lifegaurd, First Aid, etc...) & Level
Your answer
Are you involved in a local church or Faith group? Tell us about it and what it means to you and your faith.
*
Your answer
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