Alameda Education Foundation Summer Camp 2024 Youth Leadership Program Application
****Application Closed**** questions email rachel@alamedaeducation.org

This form must be completed by student and parent together with the parent providing consent by signing the form.

Thank you for your interest in the AEF Summer Camp Youth Leadership Program.  Camps begin June 17 and end July 12 and are located at Bay Farm Elementary School.

Students who apply must be available to volunteer at least 2 weeks of our camp program.  Students will either volunteer for the morning camps or afternoon camps. There is an all day Spanish and Chinese camp for two Youth Leaders.  

Please do NOT apply if the student is not available for at least 2 weeks.  

PLEASE NOTE: Students must be currently at least 14* year as of June 17, 2024; and under the age 18 year by July 12, 2024 to apply. *Unless pre-approved by AEF

Interviews will be held in person or over Zoom.  An in-person training will be held May 23, 2024 @ 4:15 PM

Application Deadline: April 25
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Email *
Student Full Name: *
Student email: *
PLEASE NOTE:  DO NOT USE your students school email address.  AEF can't send emails to those addresses.
Student Date of Birth: *
PLEASE NOTE: Students must be between 14* years of age as of June 17, 2024, and under 18 years of age as of July 12, 2024, to apply  *Unless pre-approved by AEF
Which school does the student currently attend? *
What grade is the student in (2023-2024 school year)? *
Student cell phone: *
Student Mailing Address: *
What are your pronouns
References - Two References MUST be provided *
Reference 1: Name/Phone/Email/Title required
References - Two References MUST be provided *
Reference 2: Name/Phone/Email/Title required
Parent/Guardian Full Name: *
Parent/Guardian Address: *
Parent/Guardian Phone (cell preferred): *
Parent/Guardian Email: *
Student Insurance Details:                                       *
Company
Policy Number: *
Medical Release:  TO BE COMPLETED BY PARENT/GUARDIAN *
I authorize AEF to obtain emergency medical assistance for my son/daughter if this is needed while he/she is in our charge.  I understand that my child's doctor (listed below) and I will be notified as quickly as possible of any medical emergency, and that I am responsible for the costs of emergency services.   Every student participating in the Summer Camp Internship Program must be covered by medical insurance.  If you do not have insurance, you must purchase an insurance policy.  
Physician Name: *
Physician Phone: *
Student Allergies/Medical Issues: *
If none - write "none"
Adult T-shirt size: *
My student is interested in volunteering for the morning program and can be onsite from 8:15 am - 12:45 pm each day of camp *
My student is interested in volunteering for the afternoon program and can be onsite from 1:00 pm - 5:30 pm each day of camp *
I understand that my student must commit to at least two weeks of camp. My student would like to volunteer on these weeks.  *
Required
Liability Waiver: MUST BE COMPLETED BY A PARENT/GUARDIAN *
I release, waive and discharge the Alameda Education Foundation, its directors, employees, board members, officers, agents, and independent contractors from all liability to the undersigned and/or his/her personal representation, assignees, heirs, and next of kin for any loss or damage and any claim of demands accruing or resulting from injury to the person or property of the Alameda Education Foundation, its directors, employees, board members, officers, employees, agents and independent contractors.
Liability Waiver: MUST BE COMPLETED BY A PARENT/GUARDIAN *
I hereby assume full responsibility for and risk of bodily injury, death or property damage, whether or not it is due to the negligence of the Alameda Education Foundation, its directors, employees, agents and independent contractors or otherwise while in, upon, or about the premises of the Alameda Unified School District, or City of Alameda, and/or while using the premises or facilities or equipment or program transportation thereon.
Student Code of Conduct: *
I understand that my student must behave in a respectful manner conducive to modeling good behavior. I acknowledge that my student must follow AUSD school behavioral policies and that my student serves at the discretion of the Enrichment Program Director. If my student fails to observe the above he/she maybe removed from the program.
Photo Consent:  TO BE COMPLETED BY PARENT/GUARDIAN *
I understand that photos of the Summer Youth Leaders may be published unless I submit a written "no photo release" request to AEF at info@alamedaeducation.org
Form completed by: *
Please provide the full name of the parent or guardian who completed the parent/guardian sections of this form.
Relationship to student: *
Parent/Guardian Signature *
My typed name serves as my signature.  I agree to all waivers and conditions as stated above.
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