Int_form – Waterton Lions Leadership Camp

First Name

Address

City /Town

Postal/ Zip

e-mail

Last Name

Address

State/Province

Country

Telephone

Applicants must be 15 to 18 years old

Birth Date

Grade as of 2023–2024 school year

Gender

T-Shirt Size

Enter which Lions Club is sponsoring the applicant if applicable.

Student Agreement

If I am accepted as a delegate, I agree to abide by all regulations and requirements established by the officials of the Lions Waterton Leadership Camp. This camp is SMOKE FREE. Use of alcohol and other chemical substances are strictly forbidden at all times ON and OFF the campsite during the duration of the camp. I understand that failure to abide by these, and other rules of the camp, will result in my being expelled from camp and sent home at my own expense.

Student Signature

Parent Signature

All successful applicants will be contacted and provided with further information.

Please forward the completed application form with a cheque or money order in the amount of $500.00 made payable to Lions Leadership Camp, to the address below.

Applicants must be 15 to 18 years old

Grade as of 2023–2024 school year

Gender

T-Shirt Size

Enter which Lions Club is sponsoring the applicant if applicable.

Student Agreement

Application Forms

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