Leadership Development Camp August 2 – August 5, 2018

We are excited to share information about the American Red Cross Leadership Development Camp (LDC). This is our 38th year of uniting youth from Orange, Riverside and San Bernardino counties for a unique leadership experience. LDC is a four day, three night camp where a diverse group of high school-age youth will learn to work as a team, how to overcome challenges, discover their own values and skills, and make new friends! At LDC, youth develop their leadership skills through:

Camp Site Information Cedar Lake Camp, Big Bear 1100 Mill Creek Rd Big Bear, CA 92315 www.campcedarlake.com Delegate Fee Payment due: $350 For more information, contact: Beth Ratcliff, Regional Youth Coordinator [email protected]

 Fundamental Leadership and Team Building: individual and group activities in communication, problem solving, decision making, leadership styles, group dynamics, and trust-building  Personal Development and Social Engagement: a variety of special events including a talent show, physical challenges, and entertainment  American Red Cross Mission and Lines of Service: disaster preparedness, CPR certification, and youth volunteer opportunities Our goal is to strengthen the American Red Cross by preparing current youth volunteers and recruiting new youth volunteers for leadership opportunities. To Apply: (see next pages for instructions)

☐ Step 1: Verify / Create a Volunteer Connection account ☐ Step 2: Print & Complete Required Forms ☐ Step 3: Complete Online LDC Delegate Application ☐ Step 4: Payment ☐ Step 5: LDC Orientation

August 2nd – August 5th

Application Process Deadline: April 23, 2018 All applications will be processed and evaluated for participation in LDC 2018. As there are limited spots for LDC, all applications are processed on a first come first served basis and applicants are required to be in 9th – 11th grade as of March 2018. A delegate’s position at LDC 2018 is secured once a complete application and deposit are received.

Step 1: Verify / Create a Volunteer Connection account Applicants MUST have a current and completed Volunteer Connection account in order to attend LDC. If you do not have an account, please sign up through the following link: tinyurl.com/LDCDelegateDTS *Please complete ALL steps to register as a new volunteer through Volunteer Connection. If you are unsure of the status of your account contact Youth Services at: [email protected] or 714-481-5397.

Step 2: Print & Complete Required Forms Print, complete, and scan or take a picture of the following forms found within this document:  Release Form  Health History Form  SOAR Participant Agreement  Credit Deposit Form (only if paying with credit card)

Step 3: Complete Online LDC Delegate Application Once you’ve signed up for Volunteer Connection you will receive the following link to fill out the official LDC Delegate Application: tinyurl.com/LDCApplication All applicants MUST apply through the online LDC Delegate Application, and only applicants with Volunteer Connection accounts will be able to access the application. Applicants will need to have the following information and documents to complete the LDC Delegate Application:  Basic information for applicant  Scans/pictures of the forms from Step 2  Scan/picture of applicant’s medical insurance card  Scan/picture of proof of Hepatitis A, Hepatitis B, and Tetanus vaccinations  Payment information

August 2nd – August 5th

Step 4: Payment Delegates for LDC 2018 will be charged a fee of $350 to attend camp. This amount covers meals, lodging, and transportation. A $100 deposit is required upon application submission. The remaining payment is due by LDC Orientation. Payments can be made via credit card, check, or cash:  Credit card: please complete the Credit Deposit Form found at the end of this document and upload a scan or picture of the completed form to the section titled "Payment" on the online LDC Delegate Application.  Check: should be made payable to ‘American Red Cross’ and include 'LDC' and the delegate's name in the memo line. Either hand deliver or mail to: American Red Cross Attn: Youth Services 601 N. Golden Circle Santa Ana, CA 92705  Cash: Can either be dropped off or mailed to the above address. If you need financial assistance in paying for camp:  Apply for a partial scholarship provided by the Red Cross: to request a scholarship form please email [email protected]. Scholarships are limited and provided on a first come, first served basis - please request as soon as possible.  Ask family and friends to pledge a certain amount of money for every hour of service you complete (delegates will receive a total of 60 service hours for LDC)  Apply for a scholarship by contacting your local Kiwanis Club at www.kiwanis.org  Apply for a scholarship through your local Rotary Club: www.rotary.org  Sell chocolate bars through World's Finest Chocolate Fundraising: worldsfinestchocolate.com

Step 5: LDC Orientation All LDC delegates must attend the LDC Orientation, accompanied by a parent/guardian. Orientations will be held in each chapter office. During orientation we will provide you with a general overview of each day at LDC, the departure/arrival camp times, a packing list (basics of what to bring), and answer all your questions. Your remaining payment balance will also be due at orientation. Orientations will be on the following dates and delegates are required to attend one meeting. Orange County: 600 Park Center Dr., Santa Ana CA 92705 (Room 208) May 21, 6:00pm - 7:30pm May 22, 6:00pm - 7:30pm Riverside: 6235 River Crest Dr, Riverside, CA 92507 (Training Rooms 1-2) May 23, 6:00pm - 7:30pm

August 2nd – August 5th

Release Form Parental Consent My Son/Daughter (Youth’s name) has my consent to attend the American Red Cross Leadership Development Camp (LDC) to be held at Cedar Lake Camp the week of August 2nd – 5th 2018. Release of Liability In regard to the above-named youth’s participation in the aforementioned activity, I hereby AGREE to release and hold harmless the American National Red Cross, its agents, employees and representatives from any and all liability of any kind or nature whatsoever in connection with any loss, damage or expense suffered or incurred by the above-named youth or by myself as the result of any act, intentional or unintentional, by (1) any person who is not an agent, employee or representative of the American Red Cross, or by (2) any other participant (staff and/or delegate). Release of Permission I give to the American Red Cross, its nominees, agents, and assigns, unlimited permission to use, publish, and republish for purposes of advertising, trade, or any other lawful use, information about me and reproductions of my likeness (photographic, voice or otherwise) related to the below-named youth’s participation with or without identification by name. Medical Release I authorize the American Red Cross and its adults, agents, employees or representatives consent to any x-ray examination, anesthetic, medical or surgical diagnosis or treatment and hospital care be rendered to the below-named youth under general or special supervision and upon the advice of a physician and surgeon licensed under the provisions of the Medicine Practice Act or to consent to and x-ray examination, anesthetic, dental, or surgical diagnosis by a dentist licensed under the provision of the Dental Practice Act. Also, I have indicated any medical information which the American Red Cross LDC program should be aware of in the participant’s Health History Form. I acknowledge reading and being aware of the American Red Cross policies as they pertain to the Release of Liability, Release of Permission and Medical Release for attendance at LDC 2018. My signature below authorizes my acceptance and compliance with these policies. Name of participant:

Age:

Signature: Consent of parent or legal guardian of above individual if a minor. I consent and agree, individually and as a parent or legal guardian of the minor named above, to the foregoing terms and provisions. Name:

Relationship:

Signature:

Date:

In case of an emergency, another person to contact is: Relationship to participant:

Phone:

August 2nd – August 5th

Health History Form To parents / guardians: This form is to be completed in full and returned with the rest of the application. This information would be needed in case of illness or emergency and will be kept confidential. We do not take any responsibility for a pre-condition of the youth participating in the American Red Cross Leadership Development Camp (LDC) or lack of information regarding medical history. All participants are required to submit this form prior to attending the Leadership Camp. Participant’s First Name: Address: Phone: Height: ft. in. General Physician: Health Insurance Company:

Last Name: City: Birth date:

Sex: M / F /

/

Zip code: Age:

Does participant wear glasses/ contacts (If Yes, circle which one) Phone: ( ) Policy #: (A copy of insurance card must be included in application)

If there has been any history of the following, please check: ( ) Asthma ( ) Eye trouble ( ) Depression ( ) Fainting/Dizziness ( ) Hyperactivity/ADHD ( ) Frequent Headaches ( ) Chronic cough ( ) Heart trouble ( ) Convulsions ( ) Hemophilia ( ) Deafness/Ear problems ( ) Hernias ( ) Diabetes ( ) Hives ( ) Broken bones/Joint problems

( ( ( ( ( ( (

) Anemia ) Pneumonia ) Seizures ) Sinus problems ) Sore throats ) Ulcers ) Eating Disorder

( ) Vegetarian

Comments on checked items (include diet limitations, if any):

Please list any allergies (to medicine, food, bee stings, etc):

All medications for allergies should be labeled and given to the American Red Cross Leadership Camp representative. Please list appropriate medication (s) and any medication to be taken by the participant while at the camp:

Is there any reason the participant cannot participate fully in any physical activity? If so, why?

Have you been protected by inoculation or vaccination against (please provide proof with application): Hepatitis A? (Y / N) When? _______ Hepatitis B ? (Y / N) When? ________ Tetanus? (Y / N) When? _____ Any additional health matters vital to youth’s participation in the leadership camp? In the event my child becomes ill or injured during camp activities, I authorize American Red Cross staff to seek emergency care. Parent /Guardian signature ___________________________________ Participant’s signature _______________________________________

Date: ____________ Date: ____________

August 2nd – August 5th

American Red Cross Desert to the Sea Region

2018 Credit Deposit Form Leadership Development Camp 2018

Credit Deposit Form This form will allow the American Red Cross to charge for the stated amounts, listed below. With each charge, a receipt will be emailed to the email provided below to confirm that the transaction has taken place. If you have any questions please contact Youth Services at [email protected].

Please charge a total of $_________________ for Leadership Development Camp 2018

Adult Name Youth Name Billing Address

Phone (

)

Email Credit Card Expiration Date

Security Code

Name on Card Circle one:

MasterCard

VISA

American Express

Thank you for your support!