RCEY Registration Form

To apply for the River Clinic for Empowered Youth (RCEY), please fill in the form below and upload your signed participation and waiver forms. These documents can be downloaded and printed from the below links:

To be considered for the program, we must receive your application by June 10, 2019. Please keep in mind that preference will be given to applicants that put a serious effort into their application.

Name*
First Last
Address*
Street Address Address Line 2 City Province Postal Code
Email*
Phone Number*
Date of Birth*
MM
DD
YYYY
Gender
I am
Do you have any physical or other limitations which may affect your full participation in the RCEY? Please describe.
Do you have any allergies?
Please list any allergies you have.
Which sponsorship group are you applying with?*
- School District 91
- Nadleh First Nation
- Not Applicable
What school are you attending?
How did you hear about the RCEY?*
What school or community activities are you currently involved in?*
What attracted you to the RCEY and why do you want to be a part of the program?*
Commitment: If I am accepted into the RCEY, I commit to either writing a blog post or presenting about my experience in the program.*
- Yes
- No
What experience do you have being in the outdoors/wilderness?
Give an example of when you demonstrated leadership skills:
Upload your signed Participation Agreement form*
Accepted file types: pdf, png, jpg, doc, docs.
Upload your signed Waiver/Liability form:*
If you are a minor, please make sure your parent or guardian has signed the form.
Accepted file types: jpg, png, pdf, doc, docx.
Would you like to receive email news and updates from the Rivershed Society of BC?
You can opt out at any time.
- Yes, I would like to receive RSBC email news and updates
Cancellation Policy*
By registering for this program, you are agreeing to the terms of our CANCELLATION POLICY.
- I agree
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Cancellation policy
Questions? riverclinics@rivershed.com

RCEY Registration

RCEY Registration Form

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