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2. Program Information
   Leader In Training Program Details 2023
4. First Name*
5. Last Name*
7. Date of Birth:*
8. Current Age:*
9. Gender:*
11. School:*
12. Current Grade:*
14. City
15. State
16. Zip Code
18. Address*
20. City*
21. State*
22. Zip Code*
24. Email Address*
    Applicant Email or Parent/Guardian
25. Phone *
27. Parent/Guardian Names/Phone Numbers/E-mail*
29. Please list two references.*
    Good references include teachers, youth group advisors, scout leaders, guidance counselors, etc... (No relatives or family please).
    Provide FULL NAME/How you know them/Phone number.
    
31. Please select the age group you would enjoy working with:*

    1. 5 and 6 year olds
    2. 7 and 8 year olds
32. Certification:*

    1. I have my first aid & CPR certification
    2. I NEED first aid & CPR certification
34. I can attend training on the following days (training is required)*

    1. June 19
    2. June 20
    3. June 21
    4. June 22
35. Please check the weeks you would like to participate in the LIT program:*

    1. Week 1 (June 26 - June 30)
    2. Week 2 (July 3 - July 7) No Camp July 4
    3. Week 3 (July 10 - July 14)
    4. Week 4 (July 17 - July 21)
    5. Week 5 (July 24 - July 28)
    6. Week 6 (July 31 - August 4)
    7. Week 7 (August 7 - August 11)
37. Camp History?*

    1. I have participated in Camp K.
    2. I have participated in other sports, day/residential overnight camps before.
    3. I have NOT done any kind of summer camp.
Leave This Blank:


39. 1. Receive an email copy of this form.
40. Email address

    This field is not part of the form submission.

41. Submit

* indicates a required field