LDP Online Application Form

A. Personal Information

B. Family Information

C. Church Information:

D. Medical Information:

Emergency Contact 1 (other than parent)

Emergency Contact 2 (other than parent)

E. Christian Experience Information

F. Personality Description

Choose the number that best represents your position in each of the following questions:

1 = Rarely 5 = Consistently

I study my bible
I pray
I am confident in what I do
I am outgoing
I prefer working alone
I prefer working in groups
I am more of a leader than a follower
I enjoy being given the opportunity to lead
I can lead if I have to
I am an encourager
I like it when things are organized
I am spontaneous
I am quiet
I ask for help
I struggle with low self image

G. Session Information

Which session of LDP would you like to attend? (Please number your first and second choices.)

Session 1 (July 6-17)
Session 2 (July 20-31)
Session 3 (August 3-14)
Session 4 (August 17-28)

Cost: $380. Minimum $100 deposit required for your application to be processed.

Every effort will be made to accommodate your first choice, but we are limited to 24 LDP’s (12
guys and 12 girls) per session. Sessions are filled in the order that applications come in.

FULL SESSION FEE IS DUE 2 WEEKS PRIOR TO THE START OF YOUR SESSION.

H. References

Please provide us with the outlined information of people you know well and will give an objective
evaluation of your character, abilities and work habits. Please enter your name and position you are
applying for on the enclosed Personal Reference forms before giving them to the individuals listed below.

1. Pastoral

Suggestions: pastor, youth pastor, deacon, S.S. teacher, etc.

2. Parent/Guardian

I. Mission Statement

View Mission Statement

J. Code of Conduct

View Code of Conduct

K. Agreement — Applicant

L. Waivers and Conditions of Employment

1. The acting Camp Director reserves the right to dismiss a staff member who in his/her opinion is a hazard to
safety and the rights of others, or who appears to have rejected the reasonable guidelines set for staff conduct (see
Ethic & Lifestyle Code). In such event, the staff member/parent(s)/guardian(s) are responsible for any travel
expenses that may result from the dismissal. The applicant/parent/guardian certifies that the applicant staff is
normal in condition and habits and is amenable to necessary discipline.

2. The applicant/parent(s)/guardian(s) approving this application are those having legal custody of the applicant.
Conditions of custody, if applicable, will be fully communicated in writing to the camp, including a photocopy of
the session of any court order referring to visitation rights.

3. While every precaution is taken for the safety and good health of our staff, Winkler Bible Camp Inc., its
directors, other staff members and other employees of facilities outside of the campgrounds are hereby released
from any liability in the event of an illness, accident or misfortune that may occur to the applicant staff. Each staff
must be insured by Provincial Health or equivalent medical insurance.

4. The signature of the applicant/parent/guardian on this application shall give the acting Camp Director or Medical
Officer the right to arrange for any special services or other requirements necessary for the best interests of the
applicant staff and shall give the acting Camp Director or Medical Officer the right to approve and obtain medical
attention necessary for the applicant staff’s welfare and good health including injection, anaesthesia or surgery. In
such situations the camp will attempt to notify parent(s)/guardian(s) as soon as possible. The applicant/parent(s)/
guardian(s) are responsible for any additional expenses that may result from such services.

5. The signature of the parent/guardian on this application shall give the acting Camp Medical Officer the right to
administer the use of any non-prescription drugs to the applicant staff and any relevant emergency treatment such
as CPR, epi-pen, etc.

6. The signature of the applicant/parent/guardian on this application shall authorize the appropriate police force to
make any investigation of its records and inquiries of other police forces as it may consider appropriate. It also
authorizes the said police force to advise Winkler Bible Camp Inc. whether or not such sources contain information
which in the opinion of the police force may be relevant to this application.

7. The signature of the applicant/parent/guardian on this application shall give the camp permission to use pictures
or videos of the applicant for promotional purposes.


M. Checklist

Please complete the following items.