DLDC 2021 Application

Look over the application before you start to fill it out and make sure you have all the information you need to fill it out completely (especially yours and your parents' contact information). You will not be able to save it and come back to it later. Both you AND A PARENT must sign this application.

Camp Information & Instructions

The American Red Cross of Utah will be holding its 11th annual High School Leadership Development Camp (LDC) but this year it will be an ONLINE camp only. The camp dates and times are: June 21-25, 2021 from 10am-3pm each day. This camp is for Utah, Nevada and South Western Wyoming students who are currently in 9th, 10th and 11th grades for the school year 2020-2021. LDC is designed for both students who already have strong leadership skills and for those who have no leadership experience yet. The camp is also designed for students who feel they are not the type of person for a leadership role but would like to learn how they, with their own set of values and characteristics, can help in their schools, churches and communities.

Filling out this application does not guarantee you a spot at camp. We realize that you have lots of questions, so we do a Zoom chat with all youth and their parents who apply for camp. This is not a job interview, but we do want to make sure that both the delegate (youth who attend camp) and their parents understand the camp and also agree to all that we require while in attendance. We also want to make sure parents and youth have all their questions answered. During our Zoom chat you will be quizzed on the information in our camp video (found on our website) as well as the rules and information here.

Because our camp is non-profit, the cost of camp is only $50. Payment is due during the video chat. Unless there is a very good reason. Please discuss this with the staff member.

Application Steps At-A-Glance

Fill out this new application for online LDC and agree to the terms
Do a Zoom chat with a staff member and pay for camp ($50)
Receive your top-secret package
Attend camp
Graduate to awesomeness

Contact Information

If you have any further questions regarding this camp, please contact either of the following persons:

Heather McKinnon, Camp Director
cell: (801) 688-2699
heather.mckinnon2@redcross.org

Meesh Gapinski, Camp Coordinator
cell: (801) 209-2266
meesh.gapinski@redcross.org

In order for us to stay in contact with you after acceptance to camp, you must contact Heather or Meesh at the emails listed above if you change any contact information provided on this application.

Personal Information

First Name

Preferred Name (If different)

Last Name

Gender

Street Address

City

State

Zip Code

Cell Phone (important if you have one)

Home Phone

Personal Email Address

Were you signed up for LDC last year (2020)?

If you were signed up for LDC 2020, how much did you pay?

Instagram Handle if you have one

T-Shirt Size

Current grade for 2020-2021 school year

School you will attend next year

Please list the names of any other person (both staff and attendee) who will be at camp that YOU KNOW

Ethnicity

White/Caucasian

Latino

African American

Pacific Islander

Asian

European

Middle Eastern

Native American

Other

Agree to Share Contact Information

How did you (and your parents) hear about LDC?

If a friend referred you, what is their name?

Do you have a laptop or PC that you can use for camp?

Do you have your own earbuds/headphones you can use for camp?

Will you be able to do camp in a private place with the doors closed

Do you have any food allergies or dietary restriction?

Have you ever been to a Youth Services meeting at the Red Cross?

Tell us your top 5 favorite snacks

Parent/Guardian Information

First Name

Last Name

Parents Cell Phone (important if you have one)

Home Phone

Parents Email Address (important)

Essay Section

Why do you want to attend DLDC? What do you hope to gain/learn from the experience? (One short paragraph.)

Briefly tell us about your leadership experience (Leadership experience is not required to come to camp.)

What career path are you thinking about pursuing?

Agreements

Camp Rules

You must give your full attention to camp. Surfing the internet or doing other things during camp is not allowed. You won’t grow if you aren’t present and it will honestly be a waste of your time and ours.
You must commit to show up on time each day, stay to the end of each day and come back every day of camp. If you do this we can promise you the results we spoke of in the video. If you get sick or have to leave for some reason please message Heather or have your parents message her right away.
If you miss part of camp and don't have approval from the director, you may be asked to leave the camp.
Because you will be in groups where people are sharing personal information and because we want you to feel free to share without judgment from those who may hear your conversation, we need you to be in a private space with the door closed and no one else in the room. If you can’t do this, we hope you marked in the above section that you couldn’t and we will try to help you figure out a way.
What is said by others in Rap group by others (their personal stories), stays in Rap group. We don't keep the curriculum a secret, but you must not share others personal stories without their permission.
You must agree to keep your screen on the whole time.
Get the snacks and drinks you need and have them near you so you don't have to leave.
There is no dress code but please be appropriate and don't wear things that are generally offensive.
We strive to have a diverse group of delegates. We expect all delegates to be respectful of all others at camp, no matter what your personal beliefs are.
As this is a leadership camp, the nature of your language, conversations, and actions should be civil and not make others uncomfortable.
You must be able to take feedback as it is intended... to push you to grow.
For planning purposes, we can only issue a refund to you until May 15^th, if you decide to withdraw from attending camp. After that our fee is non-refundable.

Delegate Certification and Signature

By typing my legal name and date below, I certify the following:

To the best of my knowledge all statements in this form are true, and any misrepresentation will call for immediate dismissal. I acknowledge the above information is voluntarily supplied and may be used and disclosed for Red Cross purposes only. By signing this form, I state that I have read the Camp Rules, and agree to follow them for the entire week of camp.
I hereby give the American Red Cross, its designees, agents and assignees, unlimited permission to use, publish and republish in any form or media, without compensation, any photo or video of me or recording of my voice, with or without identification of me by name.

Delegate's Typed Full Name

Parent Certification and Signature

By typing my legal name and date below, I certify the following:

To the best of my knowledge all statements in this form are true, and any misrepresentation will call for my child's immediate dismissal. I acknowledge the above information is voluntarily supplied and may be used and disclosed for Red Cross purposes only. By signing this form, I state that I have read the Camp Rules, and agree to support my child to follow them for the entire week of camp.
I hereby give the American Red Cross, its designees, agents and assignees, unlimited permission to use, publish and republish in any form or media, without compensation, any photo or video of my child or recording of my childs voice, with or without identification of them by name.

Parents Full Typed Name

Date

Things You and Your Parent/Guardian Need to Know

You will receive a link to schedule a zoom chat through calendly.com. Please do that asap.

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