Leadership - Manitoba Cooperative Association

TO R E G I S T E R
PARTICIPATION WAIVER
To be filled out by your parent or guardian.
1
Complete the registration information and
participation waiver and mail it to:
Manitoba Cooperative Association
C/O Camp Wannakumbac
Box 125, Onanole, MB, R0J 1N0
Upon receiving your registration you will receive
a confirmation email from [email protected]
so, it is very important that you include a valid
email address on your registration form —
and add [email protected] to your safe
sender’s list.
I,___________________________, parent/guardian of
________________________________________________,
(applicant’s name)
state that I voluntarily choose to have my
son/daughter participate in the Co-op Youth
Leadership Retreat with full knowledge
that there will be some risks inherent in the
activities of the retreat, and I hereby release
the directors, management and staff of the
Manitoba Cooperative Association from liability
for personal injury or loss incurred by my son/
daughter during the said retreat.
2
Look for a sponsor. Examples of sponsors are
your local co-ops and credit unions. Visit www.
manitoba.coop for tips on how to find a sponsor.
If you have difficulty finding a sponsor, please
contact us at [email protected] or at
(204) 848-2380.
Signature _______________________________________
3
Once you have found a sponsor, have them
complete the sponsorship form and submit it
along with the $350 registration fee payable to
the Manitoba Cooperative Association.
4
Arrive at the Riding Mountain Conference
Centre on April 28, 2016 between 2 - 3 pm
and be ready to have FUN!
Date ____________________________________________
DISCLAIMER FOR THE
U S E O F P H OTO G R A P H Y
During the course of the Co-op Youth (CY)
Leadership Retreat, CY staff will be taking
photographs. These photographs may be used
in the Co-op Youth Leadership Program’s future
print or electronic promotional materials and on
the Manitoba Cooperative Association’s website.
By registering for the CY Leadership Retreat you
acknowledge that your image may be taken in a
photograph and may be used for the purposes
identified above.
CO-OP
YOUTH
Leadership
A P R 2 8 TO
M AY 1
ARE YOU 15-18
The Manitoba Cooperative Association gratefully
acknowledges the financial support of the Cooperative
Promotion Board towards these retreats.
AND READY
FOR FUN?
ARE YOU READY
FOR A CHALLENGE?
RETREAT DATE & TIMES
A Co-op Youth Leadership Retreat offers an
exciting opportunity to develop leadership
skills, and learn about cross cultural
issues and values affecting society, global
development and co-ops, all in a beautiful
camp setting. You’ll meet with youth from
across the province and learn more about
yourself and others at a Co-op Youth
Leadership Retreat.
RETREAT REGISTRATION
You can look forward to 3½ days of unique group
activities, leadership exercises and outdoor
fun. You’ll be able to socialize and make lasting
friendships with others from across the province.
The Co-op Youth Leadership retreats are held at
the Riding Mountain Conference Centre, Clear
Lake. Leadership for the retreats is provided by
past participants, elected officials, members and
staff of Manitoba cooperatives and credit unions.
Name _________________________________________
Manitoba Cooperative Association
C/O Camp Wannakumbac
Box 125, Onanole, MB, R0J 1N0
Street address _________________________________
Mailing address ________________________________
_______________________________________________
(City/Town)
( Province)
( Postal code)
Phone _________________ Fax ___________________
E-mail _________________________________________
SPRING 2016
TESTIMONIALS
2:00 p.m., Thursday, April 28 to
12:00 p.m., Sunday, May 1
• Over the three days we spent together, we’d
all become good friends and it was hard to
say goodbye.
The program includes a social evening
on Saturday.
Please complete both sides of this form
and return to:
( Future correspondence will be via e-mail)
Age as of April 28, 2016 __________________________
Male
Ο
Female
Ο
School _________________________________________
• I had a great time and would enjoy coming back
as a Junior Leader. The element of fun and
games made learning easier.
Manitoba Health No. ____________________________
• This camp taught me to speak up and state my
opinions. It has also helped me become a better
leader and to respect the opinions of others.
Special health problems ________________________
FOR MOR E IN FOR MATION
Please contact Manitoba Cooperative Association at:
(204) 848-2380 or [email protected]
Personal Health No. ____________________________
_______________________________________________
_______________________________________________
Diet restrictions ________________________________
_______________________________________________