JUNIOR STUDENT (GRADES 7 & 8) APPLICATION TO ATTEND

Trillium Lakelands Arts Camp

TLAC 2017 May 21-26, 2017

Camp White Pine, Haliburton

TLAC is an arts camp for grade 7 through 12 students, offering specialized instruction for Music, Drama, Musical Theatre, Dance, and Visual Arts within an exciting camp experience. All students must have demonstrated academic ability at Level 3 or higher in the arts area they select. All students must be independent learners who are willing and able to actively participate in all aspects of the camp experience. Applications are processed in the order in which they are received and are subject to the approval of your School Principal. The application deadline is January 13, 2017 with an “early-bird” incentive of December 22, 2016. COST: Application received by December 22nd $450.00

Application received after December 22nd $500.00 More than one student attending TLAC $400.00/student

Register early to avoid disappointment. Program selections are limited. Applications arriving after January 13,

2017 will not be accepted. Shaded areas are for administration use only. Questions? Email us at TLAC@tldsb.on.ca.

Student #: Date of Birth: TLAC #:

First Name: Last Name:

Preferred Name: □ Male □ Female

School: Grade: Pick Up School:

Address:

[PHOTO] Photo is required for identification

purposes while at camp

Home Phone: Mobile Phone: Email:

Name of sibling(s) also attending TLAC:

Every student attending TLAC will receive a TLAC 2017 t-shirt at no extra charge. Students may order the additional apparel listed below. Payment must be included with submission of the camp fee and is non-refundable. All sizes are “adult.”

T-Shirt (free) □ Small □ Medium □ Large □ XL □ 2XL

Long Sleeve Shirt ($20) □ Small □ Medium □ Large □ XL □ 2XL

Hoodie ($40) □ Small □ Medium □ Large □ XL □ 2XL

TLAC Buff Headgear ($10) One size fits all, TLAC imprint

TLAC Water Bottle ($10) Stainless Steel, 24 oz.

Amount due: Amount Paid: Payment Method: (Cheque, Money Order, Cash)

□ Financial Assistance:

□ Withdrawn By: Reason: □ Deduct Admin Fee

Cabin: Bus: Alt. Transport:

□ Swim Test Required □ Swim Test Passed

TLAC 2017 Student Application – Page 2

Email: TLAC@tldsb.on.ca

COUNSELLOR/COUNSELLOR IN TRAINING APPLICATION

I am in grade 8 or higher and would like to apply to be a:

□ Counsellor in Training □ Counsellor

Each cabin requires a counsellor and a counsellor-in-training (CIT).

You must have previously been a CIT or Counsellor to be considered for the position of Counsellor.

You must be in Grade 8 or higher to be considered for the position of Counsellor in Training (CIT).

Tell us who you are, and why you are the “perfect person” to be a Counsellor or CIT. Don’t forget to mention qualities you have, that will establish how you will be an excellent role model and leader at TLAC.

Please describe your previous leadership experience, if any, including previous experience with TLAC.

TLDSB TEACHER REFERENCE

Teachers will be contacted to give a reference for student counsellor and CIT applicants. Please ask your teacher if you may use them as a reference.

Teacher Name: School:

All counsellors who are successful by meeting TLAC counsellor expetations during the full week at

camp, will earn a rebate at the end of camp of up to $150.00.

TLAC 2017 Student Application – Page 3

Email: TLAC@tldsb.on.ca

PROGRAM DESCRIPTIONS Visual Arts Theatre Arts Music

Altered T-shirts Jr. (1 period): Experiment with tye-dye and silk screen printing to create unique alterations to old t-shirts. Materials required: Bring three cotton t-shirts including at least one white t-shirt. Art from Recycled Materials Jr. (1 period): Bring new life to old materials while creating imaginative items from recyclable items.

Art Inspired By Pets Jr. (1 period): Bring a few photographs of a favourite pet(s) to use as inspiration for drawings and paintings. Clay Jr. (2 periods): Learn the basic techniques of working with kiln-fire clay and use them to create vessels, sculptures and pottery! Materials required: sketchbook, pencil, plastic bag. Claymation Jr. (1 period): Work in a small group to explore claymation that tells a story. Come prepared with character ideas and a story that could be told in less than 30 seconds. Expressive Portrait Jr. (1 period): Experiment with a variety of drawing materials to develop a series of expressive portraits. Filmaking Jr. (2 periods): Work as part of a film crew to make a short film set at TLAC. Hand Drum Making Jr. (2 periods): This is an exciting opportunity to learn about our Canadian indigenous culture through drum making. You will create a cedar hand drum with acrylic designs that represents your personal story. Mosaics Jr. (1 period): Create your own original mosaics using tiles and found objects. Photoshop and Photography Jr. (2 periods) Explore photomanipulation while creating a series of unique, bizarre, and wonderfully imaginative images by manipulating your own photography. Come prepared with a digital camera and the appropriate cables and charger. Pop Art Painting Jr. (2 periods): Take inspiration from Andy Warhol and Roy Lichtenstein to create an original pop-art masterpiece. Print Making Jr. (1 period): Experience the thrill of creating multiple images of your original ideas. Experiment with relief, collograph, gelatin and found-object printing. Ideal for the young artist who likes to experiment. Materials required: Bring an apron or art shirt.

Wire Sculpture Jr. (2 periods): Manipulate wire as you and your peers make a school of fish and a flock of birds.

Acting/Devised Theatre (2 periods): Open to students in grades 7-12 with an interest in acting. Enjoy working on monologues, blocking & spoken word in a fun, inclusive environment. Some drama experience necessary.

Ballet (1 period): Enjoy studying classical ballet in a welcoming, and encouraging environment. Open to students in grades 7-12. Focus on developing technique, musicality and grace while enjoying the art of ballet. A minimum of two years of ballet experience is required.

Dance Jr. (2 periods): Open to students in grades 7-8 with at least 2 years of dance training.

Jazz Dance (1 period): Jazz is a fundamental Broadway dance style. Open to students in grades 7-12. Come explore this well known dance technique and have some fun leaping through space! A minimum of two years of dance experience is required.

Improvisation Jr. (1 period): Have fun developing your drama skills through experiential cooperative activities! Dramatic improvisation is a great way to exercise your imagination & improve interpersonal skills and self confidence! No drama experience required.

Line Dancing Jr. (1 period): You will smile from the beginning to end of every period of line dancing! Come enjoy learning all different types of line dancing. No dance experience necessary!

Musical Theatre (3 periods): Open major for students in grades 7-12 with some stage experience. A willingness to sing and dance is necessary. This year’s musical production is “The Lion King”.

Brass/Woodwind Ensemble (1 period): a small group setting of trios, quartets, or quintets, based on the instruments in the class. Small groups will learn ensemble music. Open to students who play flute, oboe, clarinet, bassoon, saxophone, trumpet, French horn, trombone, baritone/euphonium, and tuba. Students must complete the Music Placement Video.

Concert Band Jr. (2 periods): Play some amazing tunes with some awesome people; from movie tunes, to traditional band pieces, to rock melodies, something for everyone! Grouped according to the best educational fit. Open to students who play flute, oboe, clarinet, bassoon, saxophone, trumpet, French horn, trombone, baritone/euphonium, tuba, bass guitar (must be able to read staff notation - not TAB), bells, and percussion. Students must complete the Music Placement Video.

Guitar (2 periods): Expand your guitar skills! Learn some new tunes and work within small ensembles to better your performance. This course is for students with a minimum of 1 year experience on guitar and the ability to read staff notation. Students must provide their own acoustic guitar. Students must complete the Music Placement Video.

Guitar Beginner (1 period): This course is for students with little or no experience on guitar. Learn the basics of guitar, a number of common chords and strum out a few tunes. Students must provide their own acoustic guitar. No experience necessary.

Guitar Advanced (1 period): Love playing guitar or bass guitar and want to take your performance to the next level? Solo, small group, and ensemble settings. The course is for advanced players who have three or more years of experience on guitar. Students must be able to read staff notation, TAB notation, and chord notation. Students must provide their own acoustic guitar or bass. Students must complete the Music Placement Video.

Ukulele Beginner (1 period): Have you always wanted to learn to play ukulele? This course is for students with little or no experience on ukulele. We will learn the basics, a number of common chords and strum out a few tunes. Students must provide their own ukulele. No experience necessary.

Vocals Beginner (1 period): This course is for students who love to sing but have little or no vocal experience, who like to sing and want to learn how to sing with others in a choir setting. We will learn a wide variety of pieces, from traditional vocal music, to music theatre pieces, to pop tunes and movie classics. No experience necessary.

Vocals Advanced (1 period): Take your singing to the next level! This course is for students who want to learn advanced, multi-part choral music. Students will learn a number of different styles of music and explore the world of vocal harmony. Students should be comfortable reading vocal music, be confident on their own vocal line, and sing in tune throughout their range. This course is NOT for beginners. Students must complete the Music Placement Video.

Health and Fitness (1 period)

Survival: Enjoy hiking in the woods and trails at camp, learning how to take bearings on a map with a compass, use a GPS to set your location and find treasures. Build different types of emergency shelters and have a fun team competition on the last day.

Zumba: Zumba is an energetic aerobic fitness program featuring movements inspired by various styles of Latin dance.

Active Living: For students wanting to participate in group activities (no sports). The focus is on getting heart rates high and smiles beaming during cooperative games and other fun, inclusive activities (field games, ultimate frisbee, capture the flag, man-tracker, etc.).

Sports Rotation: For students wanting to play a variety of sports. The focus is on burning lots of energy while rotating through a number of different sports (basketball, ball hockey, soccer, baseball, etc.) throughout the week in a fun and inclusive manner. Other Sports Offered: Canoe, Kayak, Tennis, Ropes, Basketball, Survival, Biking

TLAC 2017 Student Application – Page 4

Email: TLAC@tldsb.on.ca

STUDENT PROGRAM SELECTION The arts camp is set up as a typical high school day with four periods per day. Students attending have proficient skills in either instrumental music, music theatre, dance, or visual arts. Physical education options include cycling, kayaking, canoeing, tennis, swimming, zumba, survival, ball hockey, sports rotation and an active living option. A free-time period follows period four when students study, swim, read, play games, etc. Three nutritious meals are included each day as well as a light snack before bed. There is a nightly evening concert in the Pinetages Theatre featuring fantastic performances from major artists. Each evening concert begins with an art display and presentation from a local visual artist. Following the theatre presentation, a supervised study hall is provided every evening from 10 p.m. to 11 p.m. Based on the program descriptions provided for each course, highlight or circle your FIRST choice for your daily schedule.

Period selections must be different on each schedule.

STUDENT DAILY SCHEDULE - FIRST CHOICES While we will do our best to accommodate your first choices,

please be aware that all courses are subject to change or cancellation based on registration numbers.

Based on the program descriptions provided for each course, highlight or circle your SECOND choice for your daily schedule.

Period selections must be different from the above schedule.

STUDENT DAILY SCHEDULE - SECOND CHOICES

TLAC 2017 Student Application – Page 5

Email: TLAC@tldsb.on.ca

STUDENT PROGRAM SELECTION CONTINUED

Based on the program descriptions provided for each course, highlight or circle your THIRD choice below for your daily

schedule. Period selections must be different from the above schedules.

STUDENT DAILY SCHEDULE - THIRD CHOICES While we will do our best to accommodate your first choices,

please be aware that all courses are subject to change or cancellation based on registration numbers.

Music Students: NOTE: With the exception of drums and keyboard/piano, students must provide their own instruments from home, or borrow them from their home school. If you are participating in instrumental courses, please indicate the instrument(s) you will be bringing/playing: _______________________________________________________________________________ If you are participating in vocal courses, please indicate your voice range:

□ Bass □ Tenor □ Alto □ Soprano

TLDSB TEACHER REFERENCE Teachers will be contacted to give a reference for music abilities.

Please ask your teacher if you may use them as a reference.

Teacher Name: School:

The following pages require parent/legal guardian completion:

MEDICAL AND EMERGENCY CONTACT INFORMATION The following information must be completed by a parent/legal guardian. A qualified nurse is booked to be on residence for the week of TLAC. Students’ confidential medical information will be kept at the nurse's station and transported to the hospital with your child if required.

If your child's health card is not indicated, you will be billed directly for services rendered by the hospital. Any prescription medication ordered for your child will be billed to you and a receipt will be provided for your claim. Update this information if any changes occur between now and May 21, 2017.

Ontario Health Insurance Number (Optional):___________________________________

Parent/Legal Guardian’s Name:

Home Phone: Work Phone: Cell:

Parent/Legal Guardian’s Name:

Home Phone: Work Phone: Cell:

Emergency Contact: Relationship to Student:

Home Phone: Work Phone: Cell:

Family Physician: Phone:

In order to ensure the most positive experience for your child, please indicate any pertinent medical (physical, mental, emotional, social) information of which we should be aware in order to best support your child: Does your child have asthma? Yes No If yes, does your child carry an inhaler for asthma? Yes No Name of inhaler medication(s): Does your child have allergies and/or health conditions that are life-threatening? Yes No

If yes, does your child carry an epi-pen? Yes No Please give details of the condition: Student wears a MedicAlert® Yes No Registration No. Does your child have mild allergies and/or health conditions? Yes No If Yes, give details: Does your child require medication to be administered while at camp? Yes No

Medication Name Dosage

Does your child have serious dietary concerns? Yes Please list below:

TLDSB CODE OF CONDUCT

The TLAC Team aims to provide a memorable, enriching experience in the Arts. Camper COURTESY, COOPERATION and RESPECT are essential in helping maintain an enjoyable, safe, and productive learning environment. Following the TLDSB Code of Conduct will ensure a memorable experience for each student in attendance. Specifically, at TLAC: 1. Any camper who takes or damages another person’s belongings may be sent home for the remainder of the camp. 2. Campers are not allowed to smoke or possess any alcoholic beverages. This includes paraphenalia and “resources”, such as

matches and lighters. The Camp Principal has the right to send campers home for a violation of this rule. 3. Any intentional damages to Camp White Pine property will be dealt with firmly. An act is considered intentional if the activity

causing damage is foolish, unnecessary and/or warned against by staff or counsellors. 4. No weapons of any kind will be permitted at TLAC. 5. No telephone will be available for campers' use. For emergency purposes, a telephone is available with the permission of one

of the Camp Directors. 6. Cell phones are not to interfere with the camp experience. Cell phones may only be used in your cabin during free time. Cell

phones seen outside of cabins will be collected and returned at the end of camp. Cell phones that are viewed as interfering with the camp experience will also be collected.

7. There will be no refunds given for campers who are sent home. Parents and/or guardians will be responsible for the transportation of any camper sent home due to a violation of the Code of Conduct.

When you are at TLAC, you are at school. It will not feel like it, but it must always be remembered that you are in an educational setting. If you would not do it at school, you may not do it at TLAC.

I UNDERSTAND AND AGREE TO THE ABOVE STATEMENTS

PHOTOGRAPH / VIDEO CONSENT When spectators – including parents or media – are invited to school events off school property, the event becomes a public event and anyone in attendance is allowed to take photographs without first obtaining consent. Please contact your school principal or the TLDSB Communication Department (Lindsay Corporate Office) if you wish clarification. My child’s photograph, name, or artwork may be displayed in school buildings (other than the student’s classroom), in school or Board publications and websites, and in print and/or electronic media. Please note: if you choose to not give consent, your child will not be in their major session picture.

I GIVE CONSENT I DO NOT GIVE CONSENT

ELEMENTS OF RISK Educational activity programs, such as TLAC involve elements of risk. Injuries may occur while participating in activities. The chance of an injury occurring can be reduced if your student behaves respectfully and appropriately and carefully follows instructions at all times while engaged in the activity. If you choose to participate in TLAC activities, you must understand that you bear the responsibility for any injury that might occur. Trillium Lakelands District School Board does not provide accident insurance coverage for student injuries that occur on school premises or during school activities. The board makes available an Accident and Life insurance program through Reliable Life Insurance Company. Participation is voluntary and costs are to be paid by the parent or guardian. You may apply directly at www.insuremykids.com or by calling toll free 1-800-463-5437.

I UNDERSTAND AND AGREE TO THE ABOVE STATEMENTS

TLAC 2017 Student Application – Page 8

Email: TLAC@tldsb.on.ca

Thank you for applying for the Trillium Lakelands Arts Camp 2017. Please print this document and submit it, along with full payment in cash or cheque, to your school office. Applications are not considered complete until this page is received. Applications must be received with full payment. If you prefer, you may post-date your cheque, however payment must be deposited by March 31, 2017.

INVOICE

Application Fee $500.00

($450 before December 22nd, or $400 for multiple students): $

T-Shirt (SIZE): $ 0.00 Long Sleeve Shirt (SIZE): $ Hoodie (SIZE): $ Buff: $ Water Bottle: $

TOTAL COST: $ Payment can be made to Trillium Lakelands DSB in the form or cheque/money order/ bank draft or cash. Post dated cheques are accepted. Full payment must be made by March 31, 2017. If you require financial assistance to enable your child to attend TLAC, please contact Sandra Corry at 1-888-526-5552 x21257 or by email at TLAC@tldsb.on.ca. Only students who have not attended TLAC before may be considered. The deadline to apply for financial assistance is December 22, 2016. If students need to withdraw from camp, a refund will be provided less an administration fee of $50.00 to cover fees that we cannot recuperate.

ACKNOWLEDGEMENT AND PERMISSION

I certify that all information provided within the registration form is correct. I understand that in permitting my student to participate in Trillium Lakelands Arts Camp, I am assuming the risks associated with my student’s participation in this activity. I have reviewed with my student the need to act respectfully and appropriately and to carefully follow the instructions of supervisors of the activity. I acknowledge that I have read and accepted the terms of the foregoing paragraphs and I give my student,

permission to participate in TLAC on the dates listed; I have a clear understanding of and agree to follow the Trillium Lakelands Arts Camp and TLDSB Code of

Conduct and accept the consequences if the Code of Conduct is not followed; I give/do not give consent for my child’s image to be used in Board publications and websites, in print or

electronic media. I have a clear understanding of the Elements of Risk involved and accept the responsility of any injury that

might occur. I confirm that the medical information provided is current, accurate, and complete; If accepted for enrolment at Trillium Lakelands Art Camp 2017, we agree to abide by all camp regulations and

to co-operate with the Administration and Staff;. We understand that should criteria outlined not be met, participants may be sent home.

Signature of Student Date

Signature of Parent/Guardian Date

TLAC 2017 Student Application – Page 9

Email: TLAC@tldsb.on.ca

TLAC INFORMATION FOR YOUR RECORDS

Thank you for registering for Trillium Lakelands Arts Camp 2017. Please keep this information page for your records.

TLAC will be held once again at Camp White Pine in Haliburton, Sunday, May 21 to Friday, May 26, 2017. All students will be picked up on the morning of Sunday, May 21st at their local area high school. Parents are invited to a performance evening on Friday, May 26th where they can view performances and arts displays and pick up their child.

TRANSPORTATION TO CAMP Transportation to camp will be provided by TLDSB via bus from your local high school. Students will be notified of the pickup time in their Information Package sent in April.

CABINS Cabins contain beds with only mattresses provided. Campers must supply their own sleeping gear.

CAMP SCHEDULE

RECREATIONAL ACTIVITIES The recreation facilities are available for use at specified times each day. The swimming area is only open when lifeguards are on duty.

PARENT/GUARDIAN NIGHT – Friday May 26, 2017 Parents/guardians are responsible to pick up their child at Camp White Pine on Friday, May 26, 2017. TLDSB does not provide transportation home.

CAMP WHITE PINE ADDRESS Lake Placid, Haliburton, Ontario, K0M 1S0 www.campwhitepine.ca

WHAT’S NEXT? The TLAC committee will review applications to determine final student schedules.

The TLAC committee will review all Counsellor/CIT applications and contact selected students.

In April, all campers will receive a full program information package. The package will outline all details of students’ individual program, and camp in general.

Cabin information will be provided to campers by the student cabin counsellors in early May.

If students need to withdraw from camp, a refund will be provided less an administration fee of $50.00 to cover fees that we cannot recuperate.

If students need to withdraw from camp, a refund will be provided less an administration fee of $50.00 to cover fees that we cannot recuperate.

TLAC receipts for income tax purposes will be provided by email after the event.

Visit the TLAC Facebook page at https://www.facebook.com/events/1790167667874684/ to keep up with fellow campers! If you have any questions or concerns prior to the event, please do not hesitate to contact the TLAC Steering Committee at TLAC@tldsb.on.ca.

TIME ACTIVITY TIME ACTIVITY

7:00AM Road Warriors/Yoga 3:15PM – 4:30PM Period 4

8:00AM – 8:45AM Breakfast 4:30PM – 5:45PM Free Time/Study Hall

9:00AM – 10:15AM Period 1 5:45PM – 6:45PM Dinner

10:30AM – 11:45AM Period 2 7:00PM – 9:30PM Evening Program

11:45AM – 12:30PM Free Time/Study Hall 9:45PM – 10:00PM Snack

12:30PM – 1:20PM Lunch 9:45PM – 10:45PM Ready for Bed/Study Hall

1:45PM – 3:00PM Period 3 10:45PM Lights Out