Application Form
All students must complete this form to be considered for the camp.
Deadline: June 23, 2000
			
Student name:___________________________________________________________________

I am: ____Male ____Female   Preferred camp date: ____JULY 9-15 or ____JULY 16-22

Date of Birth:__________________________________________________________________

Age in July 2000______________ Grade completed July 2000________________________

Student school:_________________________________________________________________

Reserve/Band:___________________________________________________________________

Band number:____________________________________________________________________

Parent/guardian name:___________________________________________________________

Mailing address:________________________________________________________________

_______________________________________________ Postal code:____________________

Telephone: daytime________________________evening_______________________________

Fax:___________________Email:___________________________________________________

Has student attended Mi'kmaw Science Cultural Camp before?  _____YES _____NO

(To be filled out by the student)

What in science interests you?

________________________________________________________________________________

________________________________________________________________________________

________________________________________________________________________________

Why would you like to attend the Mi'kmaw Science Cultural Camp?

________________________________________________________________________________

________________________________________________________________________________

________________________________________________________________________________

(To be filled out by parent/guardian)

My child has my permission to apply to the Mi'kmaw Science Cultural Camp.

________________________________________________________	
Parent/Guardian signature		

Return to community contact person before June 8, 2000, or mail/fax to 

Mi’kmaw Kina’matnewey (Mi’kmaw Science Cultural Camp) 
115 Membertou Street
Sydney, NS
B1S-2M9
Tel: (902) 567-0336    Fax: (902) 567-0337

Mi'kmaw Science Cultural Camp 2000
Medical Safety and Release Form

Student name:___________________________Parent/ Guardian name:____________________

Band:___________________________ Provincial health card #:________________________

Family doctor:_________________________________ Doctor's phone:___________________

List any allergies:_______________________________________________________________

List any medications you are taking:______________________________________________

List any diet restrictions or special needs:______________________________________

Other comments:___________________________________________________________________

Emergency Contact (if parent guardian can not be reached):

Name______________________________________________Relationship____________________

Telephone(day)____________________________ (evening)______________________________

I grant permission for a member of the camp staff to seek medical attention for my 
child, if necessary.

Signature: ___________________________________________ Date: _____________________
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                 Mi'kmaw Science Cultural Camp Consent Form
              (Please read over the following with your child)

I am aware that my son/daughter/ward has applied to the Mi'kmaw Science Cultural 
Camp and he/she has my permission to attend if accepted.

We at the camp think it is important that both the student and the parents/
guardians know what our camp is about and what is expected of students who attend 
the camp. Please look over the information which has been provided and feel free 
to contact the Science Camp Coordinators if you have any questions. The camp is
seven days long, all day and overnight. Students are expected to participate in all
camp activities. This is because we want students to benefit from all the great 
activities we've planned. Students are expected to stay with the camp group at all 
times. If students leave the group they leave the chaperones and coordinators so we 
cannot guarantee their safety. They are also expected to attend the entire camp, 
barring exceptional circumstances. Students may not smoke, drink, or use 
recreational drugs at the camp. Students are expected to be mature, respectful and 
polite towards other students, chaperones, Elders, camp guests, teachers and others
at the Coast Guard College. They are also expected to be respectful towards the 
campus and the property of others. Students will be sent home at the guardian's 
expense if there are behavior problems that disrupt the camp, involve breaking camp
rules or the law. Guardians will be billed for damages to the campus or property 
not belonging to the student.
	
(For the student) I have read and understand the above.

(Student signature)____________________________________ Date: ___________________

(For the parent) I have read the above and I understand.

(Parent signature) ____________________________________ Date: ___________________