Salt Application Page

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SALT Application -Introductory Paragraph*
Please prayerfully consider this opportunity to be part of the S.A.L.T. program at Camp Li-Wa for summer 2019. This program is intended for high school students and especially for those who are serious about their faith in Christ and have a deep desire to grow. Team members will experience practical leadership training classes as well as the opportunity to model servant leadership. Camp Li-Wa reserves the right to dismiss/deny those who are not qualifies/capable to fill these positions. I have read and understand:
- Yes
- No

S.A.L.T. Session First Option*
S.A.L.T. Session Second Option*
S.A.L.T. Session Third Option*
Product Name
Price: $0.00
Certifications
- First Aid/CPR
- Archery
- Rifelry
- Certified Horsemanship Association
- Food Workers Card
PERSONAL INFORMATION:
Name*
First Last
Age*
Gender*
Birth Date*
Mailing Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Permanent Address (if different)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email*
Phone*
Shirt Size*
Siblings attending camp
Schools Attended*
Church Affiliation (if any)
Limitations

Are there any reasons why your duties might be limited due to physical limitations?
Describe your health
Have you ever had a driver’s license suspended or revoked for any reason?*
If yes, please explain
Have you ever been accused, investigated, charged, or convicted of a crime involving child abuse, child pornography, domestic violence, or attempted sexual molestation of a minor?*
If yes, please explain
Have you been accused, investigated, charged, or convicted of any other crime (other than a minor traffic violation)?*
If yes, please explain

PERSONAL INFORMATION: