S.A.L.T. Application

STOP! Before filling out this application make sure
1. That you're on a real computer.
2. That you have time to complete the application.
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

PAST CAMP INFORMATION:
Have you been a camper at Camp Li-Wa before?
- Yes
- No
If yes, which program did you attend? What year did you attend?
Are you a Christian? And how did you become a Christian?*
Commitment Statement
I am willing to obey the rules of Camp Li-Wa and to follow the instructions of those who supervise me. I choose to cooperate fully in every regard, and to explore opportunities available for spiritual growth. I understand that anyone demonstrating a negative attitude or poor quality of service is subject to dismissal.*
- I Agree
Parental Agreement Statement
I have read the statement of commitment above and understand its importance. I will not hold Camp Li-Wa or Victory Ministries Inc. responsible for injury or illness incurred by my child while attending Camp Li-Wa. I agree to have my child participate at Camp Li-Wa under the prescribed conditions.*
- I Agree

PERSONAL INFORMATION: