Youth LEAD Program Application

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Thank you for your interest in applying to an ETC Youth LEAD Program Summer Course!

The following form should be completed by the youth applicant and a parent or guardian.

Application Process:

Application deadline: April 16th, 2023
Please fill out this form completely, including the Participation Packet attachment.
Note: You may save and resume your progress at any point by checking the "Save my progress and resume later" box at the top of this form. You will receive an email with steps on resuming your application.
Once your form is received, we will schedule a virtual interview (this step applies for youth applying as Individuals and not through an organization).
After review of your medical information and all application components, you will receive an email with the decision on your course participation!

*If you are applying as an individual and are interested in a scholarship, please fill out the scholarship form HERE (versión en español aquí) and send it to ylp@etctrips.org within 10 days after your interview. If you are applying through an organization, scholarships will be arranged separately.
**Your course deposit (50% of your course cost) is due two weeks after your acceptance. If you are applying with an organization, payment will be organized through the partner organization/agency.

If you have any questions or would prefer to speak with an ETC Staff member, please contact Isabela Celedón, the Youth LEAD Program Manager, at 415.474.7662 ext. 16 or ylp@etctrips.org.

1. APPLICANT

Are you applying through an Agency/Organization or as an Individual?

What organization are you applying through?

Which course are you interested in?

How did you hear about ETC's Youth LEAD Program?

Have you attended an ETC trip before?

If you have been involved with ETC in the past, please tell us about your past ETC experience.

2. APPLICANT INFORMATION

First Name:

Last Name

Birthdate

Cell Phone:

Home Phone:

Applicant Email Address (Please check this email address frequently for important information regarding your application and next steps!)

Home Street Address:

City:

State:

Zip Code:

School

Current Grade

What is your language preference?

Gender Identity:

Pronouns (Select all that apply by clicking "Add another repsonse")

*Cisgender: term for someone who exclusively identifies as their sex assigned at birth. The term cisgender is not indicative of gender expression, sexual orientation, hormonal makeup, physical anatomy, or how one is perceived in daily life.

Which of the following best describes you? Select all that apply by clicking "Add another response"

If you are applying as an Individual (not through another organization), will you be applying for a Scholarship?

YesNo

Do you qualify for free & reduced lunch?

YesNo

Please note that COVID-19 vaccination is highly encouraged – a COVID infection during a Course will likely require cancellation of the entire course. Are you fully vaccinated for Covid-19?

YesNo

If applicable, please upload a photo (jpeg, pdf, png, gif) of your COVID-19 vaccine card.

ETC's mission is to make the joy and challenge of outdoor adventure accessible to all. In the space provided below, please inform us if you have any special needs, disabilities, or medical conditions that we should be aware of. This will help us to work together to make sure that you are in the Youth LEAD summer course that is right for you!

Please let us know of any special needs here. More detail can be provided in your Participation Packet (section 7).

3. PARENT/GUARDIAN 1 INFORMATION

Parent/Guardian First Name:	Parent/Guardian Last Name:
Parent/Guardian Email Address (if none, leave blank):	Parent/Guardian Primary Phone
Parent/Guardian Alternate Phone Parent/Guardian Relationship to Applicant

4. PARENT/GUARDIAN 2 INFORMATION

Parent/Guardian 2 First Name:	Parent/Guardian 2 Last Name:
Parent/Guardian 2 Email Address (if none, leave blank):	Parent/Guardian 2 Primary Phone
Parent/Guardian 2 Alternate Phone Parent/Guardian 2 Relationship to Applicant

5. EMERGENCY CONTACT INFORMATION

Emergency Contact First Name

Emergency Contact Last Name:

Relationship to Applicant:

Emergency Contact Phone

6. GET-TO-KNOW-YOU QUESTIONS – To be completed by Applicant

1. What interests you about joining ETC's Youth LEAD Program?

2. What sort of experience do you have with being in nature, hiking, camping
and/or any other outdoor activities? (No experience needed!) What excites you about spending time in nature?

3. Participating in a Youth LEAD Course involves being in nature with a small group for an extended period of time: taking care of each other and yourself is essential. In what ways do you support the people you care about? How do you like to be supported by others? How do you take care of yourself?

4. Tell us about a challenge you've faced in your life and what you learned from the experience.

5. For many Youth LEAD participants this is the longest time they've spent away from loved ones. What feels scary (if anything) about leaving home for this Youth LEAD Course?

6. Anything else you would like to share with us?

7. PARTICIPATION PACKET

The Participation Packet includes medical questions and other necessary forms to ensure your participation in a Youth LEAD Course.

Please fill out and sign this packet with a parent/guardian. Be sure to check that all questions and signatures have been completed before submitting!

In order to ensure safe and fun experiences for all students, it is crucial that we receive thorough and accurate medical information from all student applicants. All medical and personal information will be reviewed confidentially. If you have any questions about this process, let us know here:

Access the Participation Packet –> HERE! <–
You can fill it out on Google Chrome, then save your copy to your computer. Or, you can download it first, and then save your completed copy. Thank you for filling out the medical questions with detail and accuracy!

Upload your completed Participation Packet here:

8. AGREEMENTS

Youth Agreement – To be read and completed by Applicant:

As the youth applying for this program, by typing my name below, I confirm that I have read the course description. Further, I understand that the Youth LEAD course could be physically and emotionally challenging and involves living with a group of diverse participants WITHOUT cell phone communication for extended periods of time (5-10 days at time).

Parent Agreement – To be read and completed by Parent:

As the legal guardian of the above mentioned participant, by typing my name below,
I give the permission for them to participate in a Youth LEAD summer course. I have read the course description and I understand that the Youth LEAD course could be physically and emotionally challenging, involves living with a group of diverse participants, and not being in cell phone communication for extended periods of time (5-10 days at a time).

If you have any questions, or would prefer to speak with an ETC Staff member regarding this application, please contact Isabela Celedón, the Youth LEAD Program Manager, at 415.474.7662 ext. 16 or ylp@etctrips.org.

Once you are ready to submit this application, please click the "Submit" button at the bottom of this page! The next page will provide information on next steps.

Note: You may save and resume your progress at any point by checking the "Save my progress and resume later" box at the top of this form. You will receive an email with steps on resuming your application.

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