Hello LIT applicants!
Please take a few minutes to read through the following details carefully. This is information
about the LIT application process and important things to know about the program itself.
Missing steps or skipping over details could mean a longer time in processing your application.
There are two steps in the Leader In Training application process:
Step 1: Submitting your Camper Application, which can either be filled out online at
www.brantfordcirclesquare.ca or by completing a paper application. Submitting this portion of
your application, along with a $100 refundable deposit, will tentatively hold a spot in the
program for 6 weeks while you complete the other portions of the application. This does not
guarantee the applicant will be accepted into the program. If you are applying online, the forms
that must be completed for Step 1 include the “Household Form”, “Conditions of Enrollment”,
“Camper Information Form”, “Medical Form”, and the “LIT Reference Information”.
Step 2: Completing the Additional LIT Application, which includes:
*
*
*
*
*
LIT Supplementary Questions
LIT Declaration
IVCF Statement of Faith
IVCF Code of Conduct
Submission of LIT References
These components can either be filled out by logging back into your online account or by
mailing, faxing, or emailing in the completed forms.
Important things to note:
* Your application cannot be processed until all components are received.
* If you are accepted into the program you will be required to pay the balance owing for the
LIT course by June 1st, 2016.
* Upon acceptance, LIT participant is required to submit a police check before beginning their
placement week.
The purpose of LIT is to develop young Christian leaders who are equipped for service both at
camp and in the wider community - this kind of growth can be hard work, but the rewards are
significant. LIT is for people who have an intentional, meaningful relationship with God, who
sincerely desire to follow Jesus with their lives, and who want to become effective leaders in the
camp setting. LIT is intended to help you become the person God has always wanted you to be.
Looking forward to seeing you this summer,
Steve & Andrea Richardson
Executive Camp Directors
2016 BRANTFORD CAMPER APPLICATION
CAMP SESSIONS
Please select 1st, 2nd & 3rd choice of week
DISCOVERY CAMP | $535
1 July 3 - 9
2 July 10 - 16 (All Girls)
3 July 17 - 23
3 July 17 - 23
4 July 24 - 30
5 July 31 - August 6
5 July 31 - August 6
6 August 7 - 13 (Teen Week)
7 August 14 - 20 (All Girls)
8 August 21 - 27
8 August 21 - 27
1645 Colborne Street East
Brant, ON N3T 5L4
brantford@csranch.ca
p. 519.754.0171
f. 519.754.5490
www.brantfordcirclesquare.ca
CAMPER INFORMATION
First Name:
Apt. #:
City:
Prov:
HORSE LOVER'S | $635
1 July 3 - 9
2 July 10 - 16 (All Girls)
4 July 24 - 30
6 August 7 - 13 (Teen Week)
7 August 14 - 20 (All Girls)
Postal Code:
Home Phone #:
Camper's Email:
Camper's Date of Birth: MM-DD-YYYY
Age at Camp:
M
Gender:
F
Room/Group mate choice: (only two requests - should be same age)
PARENT / GUARDIAN INFORMATION
Camper lives with:
Both Parents
Mother
(whom the camper is living with)
Father
Guardian
Foster Parent
Joint
Mother/Guardian: (Full Name)
Cell/Bus #:
Father/Guardian: (Full Name)
8 - 12
8 - 13
8 - 12
14 - 16
9 - 13
EQUESTRIAN | $915
1 July 3 - 9
Foundation
2 July 10 - 16 (All Girls)
Intermediate
3 July 17 - 23
Intermediate
4 July 24 - 30
Foundation
5 July 31 - August 6
Intermediate
6 August 7 - 13 (Teen Week)
Advanced
7 August 14 - 20 (All Girls)
Intermediate
8 August 21 - 27
Foundation
DAY CAMP
$220 (5 Day Camps | $20 lunch option available)
$185 (4 Day Camps | $16 lunch option available)
*Children must have turned 5 by the session start date.
Cell/Bus #:
Parent Email: (Confirmation will be sent to this address)
3rd Party Emergency Contact:
Relation to Camper:
How did you learn about CSR?
Phone #:
Relative
Friend
Church
Facebook
Website
TV
Referred by: (Please give friend or relative's name)
Location?
Has camper or sibling attended CSR camp before?
Yes
Is there a brother/sister attending this year?
No Name(s):
Yes
Does your family participate in a church or faith community?
No
Yes
No
Name of church or faith community if 'Yes':
Has either parent/guardian been involved with CSR?
Yes
No
If yes, please indicate your type of involvement:
Camper
a
JUNIOR CAMP | $420 (overnight opt. Sunday $40 | Friday $50)
3 July 18 - 22
6-9
5 August 1 - 5
6-9
7 August 15 - 19 (All Girls)
6-9
Last Name:
Address:
8 - 12
8 - 13
8 - 11
12 - 14
8 - 12
8 - 11
12 - 14
14 - 16
9 - 13
8 - 11
12 - 14
Staff member
Volunteer
Year(s)?
We respect your privacy and never sell, trade, rent, or otherwise share personal information. All personal information
received by Inter-Varsity Christian Fellowship of Canada is handled with strict confidentiality for the purposes of enrolling
your child in Circle Square Ranch and for subsequent communication with you. If you have questions or concerns, please
contact us at 519.754.0171.
1 July 4 - 8
6 - 10
2 July 11 - 15
6 - 10
3 July 18 - 22
6 - 10
4 July 25 - 29
6 - 10
5 August 2 - 5 (4 Days)
*5 - 9
6 August 8 - 12
*5 - 10
7 August 15 - 19
6 - 10
Other
8 August 22 - 26
6 - 10
9 August 29 - Sept. 1 (4 Days)
*5 - 9
EXTREME DAY CAMP
$280 Discovery (Week 4 & 8 | $20 lunch option available)
$220 Discovery (Week 5 | $16 lunch option available)
$220 Adventure | $255 Horse ($16 lunch option available)
4 July 25 - 29 (Discovery) NEW!
10 - 13
5 August 2 - 5 (Discovery) NEW!
10 - 13
8 August 22 - 26 (Discovery) NEW!
10 - 13
9 August 29 - Sept. 1 (Adventure)
9 - 13
9 August 29 - Sept. 1 (Horse)
9 - 13
BOYS' CAMP | $535
4 July 24 - 30
8 August 21 - 27
8 - 12
8 - 12
252 CREW | $445
3 July 17 - 23 (All Boys)
7 August 14 - 20 (All Girls)
14 - 15
14 - 15
Route 4:13 | $815
4-5 July 24 - August 6
13 - 14
LIT | $1025 (additional application required)
1-3 July 3 - 23
15 - 16
ELITE - Supported LIT position for ages 16+.
Contact office for separate application.
©2016 Inter-Varsity Christian Fellowship of Canada. All Rights Reserved.
Page 1 of 3
For more information go to
www.brantfordcirclesquare.ca
2016 BRANTFORD CAMPER APPLICATION
CALCULATION AREA
www.brantfordcirclesquare.ca
SEND PAYMENT AND COMPLETED APPLICATION
FOR PROCESSING
Check here if registering for more than 1 week.
(see Camp Sessions) Camp
Fee
(Junior) Overnight
Fee
(Day Camp opt.)
(see box) Less
Lunch Fee
Any Discounts
(Day Camp exempt) 13%
HST
Week in Review DVD $22.50
(option for Discovery, Equestrian, Horse Lover's,
LIT, 252 Crew, Boys & Route 4:13 Camps only)
Week in Review Download $17.50
(option for Discovery, Equestrian, Horse Lover's,
LIT, 252 Crew, Boys & Route 4:13 Camps only)
Donate to Brantford Scholarships
and help another child enjoy the CSR experience.
Income tax receipts will be issued for donations
over $15.
Total
1. Full payment.
2. Deposit of $200 for Horse Lover's, Route 4:13 and Equestrian
Camps; $100 for Discovery, Boys, LIT, 252 Crew and Junior Camps;
or $50 for Day Camp, with the balance of fees enclosed as post
dated cheque dated no later than June 1, 2016.
3. After June 1, 2016 full payment to be made by credit card or
money order.
Payment methods can be MasterCard, Visa, cheque or money order.
Family Discounts
- Day Camp: 2nd child $15
- Junior Camp and 252 Crew:
2nd child $40
- Other Camps: 2nd child $50,
3rd child $100
Multiple Week Discounts
- Day Camp: 2nd week $15
- Junior Camp and 252 Crew:
2nd week $40
- Other Camps: 2nd week $50
Cheque payable to:
Circle Square Ranch
Credit Card
MasterCard
Visa
REBATE OR CREDIT
(not calculated on this form)
For each 1st time camper that you refer to CSR,
we will award you a 2016 rebate or a larger 2017
credit. Refer five & your week is free! (Your name
must be on their application to receive rebate.
Siblings are not eligible as 1st time friends. Nonapplicable to agency paid fees.)
Card Number:
CVV Code:
Expiration Date:
Cardholder Name:
Signature
HEALTH & SAFETY
Health and Safety are emphasized at all times at Circle Square Ranch.
We have a qualified medical person on staff and a hospital 15 minutes from the camp property.
Camper's Health Card #:
Expiry Date:
MM-DD-YYYY
All campers must have medical insurance.
Please answer the following questions. If applicable, attach a detailed note for any that you answer yes:
No
- Does your child have any allergies (food, drug, environmental)? Yes
No
- Does your child have any special health concerns? Yes
No
- Does your child have any conditions (mental, physical or behavioural) that require medication or treatment while at camp? Yes
Please attach detailed note on the condition(s), medication(s) and dosage if 'Yes'. Due to the structure of our program, and for the benefit of your child,
Circle Square Ranch requests that medication required throughout the year be sent with your child to camp.
No
- Is your child on a medically prescribed meal plan or dietary restriction? Yes
No
- Does your child have emotional or behavioural issues that the camp should be aware of? Yes
No (Additional fee may apply.
- Does your child have any conditions (mental, physical or behavioural), which requires one on one staff support? Yes
Please contact office for availability.)
Yes
No
Conscience or Religious Exemption
- Are immunizations up to date including tetanus booster?
- Date of last Tetanus Booster: MM-DD-YYYY *If immunizations are not up to date, please plan to have them made current before camp.
- Please indicate height / weight as some activities at camp have a minimum or maximum height and/or weight requirement:
Height:
Weight:
Has your child experienced, or is currently experiencing, any of the following conditions: (Please check all that apply & provide a detailed note)
ADD/ADHD
Asthma
Mental Health Issues/ Depression
Eating Disorder
Bedwetting
Concussions / Blackouts / Fainting
Stomach, Digestive or Constipation / Diarrhea
Epilepsy / Seizures
Headaches
Speech, Vision or Hearing Problems
Homesickness
Sleep Troubles / Sleep Walking / Nightmares / Terrors
Restrictions on activity
Other
Authorization for Treatment
1. I hereby authorize the camp personnel to handle any medical problems with my child during his/her stay at camp.
2. In the event that a camper requires special medication, x-ray, or treatment beyond that which is possible at camp, we will attempt to notify the parents
as soon as possible. The parent/guardian will be responsible for any additional expense for additional care or transportation.
3. In case of surgical emergency, I hereby give my permission to the physician selected by the Camp Director to hospitalize, secure proper treatment for,
and order injection, anesthesia, or surgery for my child named on this application.
4. I will inform the camp if my child has had any changes in health, including any communicable disease within the three weeks prior to his/her stay at the
camp.
5. Inter-Varsity's Circle Square Ranch has my permission to contact my family doctor as necessary to ensure the best care for my child/ward.
6. I give permission to Inter-Varsity's Circle Square Ranch to give the Over the Counter medications checked off.
Appropriate Cold Formula
Dimenhydrinate (Gravol)
Acetaminophen (Tylenol)
Antacid
Appropriate Allergy Formula
Antidiarrheal Formula
Ibuprofen (Advil/Motrin)
The medical information given is correct, to my knowledge, and the person herein described has permission to engage in all prescribed camp activities,
except as noted by myself. The camp retains the right to dismiss any camper whose condition has not been disclosed to the camp staff. Each camper
must be covered by medical insurance prior to arrival at camp and must extend throughout their entire time at camp.
Doctor:
Phone #:
Page 2 of 3
MM-DD-YYYY
Send completed application with payment to:
Signature
ofRanch
Parent| /1645
Guardian
Circle
Square
Colborne Street E. | Brant, ONDate
| N3T 5L4
2016 BRANTFORD CAMPER APPLICATION
www.brantfordcirclesquare.ca
CAMP INFORMATION
Fee includes all meals for overnight camps, housing, use of all recreational equipment and facilities, instruction in activities, and awards.
Fee does not include meals for Day Camp, transportation to and from the ranch or tuck shop purchases. Weekend accommodations
may be arranged for campers registered for two consecutive weeks. Please contact the office for fees and details.
Financial assistance is available for those who qualify. Assistance is at the discretion of the Ranch Director. Contact the office for
information and a scholarship application. The deadline for applications is June 1, 2016.
Nut/Peanut Policy: Inter-Varsity's Circle Square Ranch cannot guarantee to be a nut/peanut free environment. We do seek to reduce
the risk of exposure and therefore do not use or serve peanuts, peanut products or tree nuts on camp property. Nuts or products
containing nuts will not be available in our Tuck Shop(s). However the food we purchase may contain traces of nut products. Please do
not send any food items to or with your camper that contain nut products (this includes chocolate bars, granola bars, etc.). Any items
containing nut products will be removed from the camp.
Cancellation Policy: If you cancel more than two weeks prior to the start of camp, you will get a full refund less $75/week
administration fee. If you cancel less than two weeks prior to the start of camp, you will get NO REFUND (includes camp fees, out-trip
fees, and transportation fees) except for medical reasons with a note from a doctor. In that case, you will get a full refund less $100/
week administration fee. No refund will be made for dismissals due to disciplinary action, late arrivals or early departures. Withdrawal
during camp on physician's orders will result in the value of fees for the unexpired term being refunded.
Confirmation of Enrolment will be sent to the email or mailing address indicated on the application upon receiving your completed
registration and payment. Final acceptance of applicant is at the discretion of the Camp Director. Camp information packages (what to
bring, directions, arrival and departure, tuck shop) will be emailed or mailed to you.
CONDITIONS OF ENROLMENT
1. The parents/guardians submitting this application are those having legal custody over the child. Conditions of custody, if applicable,
will be fully communicated in writing to Inter-Varsity’s Circle Square Ranch, including a photocopy of the section of any court order
referring to visitation rights.
2. The Camp Director reserves the right to dismiss a camper who, in the Director’s opinion, is a hazard to the safety and rights of others,
or who appears to have rejected the reasonable controls of camp and/or whose behaviour is placing unacceptable constraints upon
the staff and their responsibilities toward other campers. This may range from missing an activity to complete dismissal depending on
the situation. In the instance that a camper is dismissed from camp for any reason, the parents/guardians are responsible for pick-up
of the dismissed camper.
3. If the camper has any physical, emotional, developmental or behavioural need, particularly if it is a condition that would require
special attention or exclude the camper from any camp activity, describe fully on a separate sheet of paper. Inter-Varsity’s Circle Square
Ranch retains the right to dismiss any camper whose condition has not been disclosed during the application process.
4. I, the parent/guardian of the herein named participant, release Inter-Varsity Christian Fellowship of Canada and Circle Square Ranch,
its trustees, directors, corporation members, staff and agents from any loss, personal injury, accident, misfortune or damage to the
herein named or his/her property, with the understanding that reasonable precautions shall be taken to ensure the health and safety
of the herein-named camper. This release is for both while the camper is on site and any camp-related off-site trip/activity. Each
camper must be covered by Provincial Health Insurance or equivalent medical insurance prior to arrival at camp and must extend
throughout their entire time at camp.
5. The parent/guardian agrees to permit reasonable use of photos, videos or other pictures of the applicant camper in promoting InterVarsity’s Camps and/or camp activities and programs, and/or Inter-Varsity Christian Fellowship in general in printed and/or electronic
media.
6. Inter-Varsity’s Circle Square Ranch encourages our staff to keep in contact with campers periodically throughout the year. I the
parent/guardian permit such contact.
7. I give my permission for Inter-Varsity to communicate camp information or registration opportunities to me electronically.
8. The parents/guardians hereby agree to reimburse Inter-Varsity’s Circle Square Ranch for any wilful damages caused by the applicant
camper.
9. The use or possession of alcohol, illicit drugs, or cigarettes by campers is strictly prohibited.
10. The parent/guardian agrees to be responsible for the payment of all fees due to the camp by June 1, 2016. This registration is not
complete until all fees are paid.
I have read and understand the Conditions of Enrolment, including
the Cancellation Policy and Camp Information and hereby accept
the conditions listed.
Signature of Parent / Guardian
Page 3 of 3
MM-DD-YYYY
Date
Send completed application with payment to:
Circle Square Ranch | 1645 Colborne Street E. | Brant, ON | N3T 5L4
2016 Circle Square Ranch
LIT Supplementary Application
Name: ______________________________________________
Your answers to the following questions will help us to better understand you and will be considered in
determining acceptance to the program. Please answer questions on a separate paper.
1. What do you think the LIT program is about?
2. Why do you think LIT is a good fit for you at this point in your life?
3. LIT is about developing leaders. What is your understanding of leadership?
4. Who is Jesus? What does He mean to you?
5. How did you become a Christian?
6. What does it mean to be a Christian?
7. What do you do to grow in your faith?
8. What spiritual or God questions are you wondering about at this point in your life?
9. What are your strengths? (Please list at least three)
10. What are your weaknesses? (Please list at least three)
11. Have you had any previous experience with camp (Circle Square Ranch or elsewhere)?
a. If yes, please describe it.
12. Describe your work and volunteer experiences, indicating type of involvement and duration.
13. Select an experience you had while working or volunteering and tell what you learned about
yourself.
14. Do you have any experience horseback riding or teaching others to ride? If so, please describe.
Many past LIT's have stated that their experience in the LIT program produced significant changes or
growth in their lives.
15. What do you want to gain from this experience? What changes do you hope to make in your life
as a result of the LIT program?
LIT DECLARATION
Please note that this section is part of the application package. Your application cannot be
processed without the completion of this portion, which will be kept in a confidential file.
There are a number of sensitive issues in our society that we must be aware of as an
organization that works with children. As a result, we are asking the following questions of
every staff member and volunteer at Circle Square Ranch.
Do you have a criminal record involving physical or sexual abuse of children?
(Choose one: Yes, No, Decline to answer)
Have you ever been investigated by any police force or Children’s Aid Society regarding
allegations of child abuse?
(Choose one: Yes, No, Decline to answer)
Upon acceptance, LIT participants are required to submit a police check before
beginning their placement week.
NOTE: Circle Square Ranch reserves the right to reject any applicant based on the results of
the Police Check and response to above questions.
Signature
By signing here I affirm that the information in this declaration is correct.
Signature:_______________________________________
Date: ___________________________________________
Inter Varsity Christian Fellowship
Statement of Faith
We believe in:
 The only true God, the almighty Creator of all things, existing eternally in three persons
– Father, Son, and Holy Spirit – full of love and glory.
 The unique divine inspiration, entire trustworthiness and authority of the Bible.
 The value and dignity of all people: created in God’s image to live in love and holiness,
but alienated from God and each other because of our sin and guilt, and justly subject
to God’s wrath.
 Jesus Christ, fully human and fully divine, who lived as a perfect example, who assumed
the judgment due sinners by dying in our place, and who was bodily raised from the
dead and ascended as Saviour and Lord.
 Justification by God’s grace to all who repent and put their faith in Jesus Christ alone for
salvation.
 The indwelling presence and transforming power of the Holy Spirit, who gives to all
believers a new life and a new calling to obedient service.
 The unity of all believers in Jesus Christ, manifest in worshiping and witnessing churches
making disciples throughout the world.
 The victorious reign and future personal return of Jesus Christ, who will judge all people
with justice and mercy, giving over the unrepentant to eternal condemnation but
receiving the redeemed into eternal life.
To God be glory forever.
Signature
By signing here I affirm that I have read and agree with the statement of faith.
Signature:_______________________________________
Date: ___________________________________________
Inter Varsity Christian Fellowship
Code of Conduct
The Code of Conduct applies to all staff and volunteers, and must be read and agreed upon by the LIT
applicant.
All staff and volunteers of Inter-Varsity Christian Fellowship testify to a personal faith in, and allegiance to, Jesus Christ.
They are committed to personal, moral and spiritual development as followers of Jesus Christ. As representatives of Christ,
all Inter-Varsity staff and volunteers demonstrate Christian commitment and a lifestyle which models and reflects the life of
Christ. The Christian Scriptures are the supreme authority and guide for the Christian believer's conduct and doctrine,
hence the specific standards of ethical practice and conduct articulated in the policy are guided by our understanding of
Scripture, our commitment to its authority and affirmation of our Doctrinal Convictions. Scripture teaches that believers are
not to be conformed to the view and lifestyle of the world. Therefore, Inter-Varsity staff and volunteers are to avoid all
practices and conduct which are morally wrong, both in private and public spheres.
Based on Scripture and our evangelical beliefs, Inter-Varsity Christian Fellowship values lifestyle conduct that reflects the
following attributes, as seen in the representative Scriptures:
 Practice of spiritual disciplines of the Christian faith (Acts 6:4; Matthew 9:15)
 Commitment to wholeness of the individual Physical health (I Corinthians 6:19)
o Mental health (Romans 12:2)
o Emotional well-being (Galatians 5:22, 23)
o Spiritual health (Luke 9:23, 24)
 Sexual purity (Ephesians 5:3)
 Commitment to truthfulness (Ephesians 4:15)
 Integrity (Ephesians 5:8-10) and justice-keeping (Micah 6:8)
 Excellence (II Timothy 2 & 3)
 Good stewardship of resources (Genesis 1:28; Exodus 20; Philippians 4:8; Ephesians 4:25-5:5)
o Human
o Financial
o Physical
o Social
o Spiritual
 Respect for the dignity and rights of others (Colossians 3:5-11; I Peter 3:13-16)
 Respect for creation (Genesis 1:28-30)
Behavioural Expectations
Consistent with our Doctrinal Convictions, Core Purpose and Core Values, and having lives shaped by Scripture, we commit
to the following behaviours:
Attitude: Each staff and volunteer's personal disposition and attitude are to be characterized by godliness and the fruit of
the Spirit which is love, joy, peace, patience, kindness, goodness, faithfulness, gentleness and self-control. Attitudes of
greed, jealousy, envy, lust, bitterness, unrestrained anger and unwillingness to forgive are condemned in Scripture and are
to be avoided.
Respect: Inter-Varsity staff and volunteers are to show respect and love to all with whom they deal, treating others with
courtesy, fairness, consideration and servanthood.
Language: Inter-Varsity staff and volunteers are to have language that is neither profane nor vulgar.
Harassment: Inter-Varsity staff and volunteers must not harass or cause harassment of or to any other person. Sexual
harassment is defined as any unwelcome sexual conduct, advance, request, gesture, speech or innuendo. Other
harassment may be based on such traits as ethnicity, ability or appearance. Harassment results in the unreasonable
interference with an individual's performance or creating an intimidating, hostile or offensive environment. If a staff
member or volunteer feels he or she has witnessed harassment, to self or another, by another staff or volunteer, he or she
is to report it to his or her supervisor and Human Resources immediately.
Lawful: Inter-Varsity staff and volunteers are not to engage in illegal activity and are to uphold biblical principles of
relationship in business, community or other associations.
Discretion: Staff and volunteers are expected to practice discretion in the following: use of tobacco; alcohol; gambling;
media and entertainment consumption; printed matter; and, the choice of organizations with whom they associate. We are
accountable to a supporting public who may hold different views on Christian behaviour. A guiding principle is to avoid
situations that may have a negative spiritual impact on self, others and Inter-Varsity Christian Fellowship.
Camp staff and volunteers will refrain from smoking, consuming alcoholic beverages and the use of illicit drugs (including
during time off) while serving at Camp.
Abstinence: Staff and volunteers are to abstain from pornography, occultism and all practices contrary to a Christian
world view.
Appearance: Staff and volunteers should dress appropriately for the occasion, activities and environment in which they
will be involved.
Sexual Expression: Inter-Varsity staff and volunteers are to follow biblical standards of sexual expression. For those
married, sexual faithfulness is the standard; for the unmarried, chastity. Premarital, extramarital, homosexual and lesbian
sexual conducts are not to be practiced. Sexual activity is not to occur outside of a male/female marriage. Teaching and
communicating beliefs that are contrary to these stated practices is not tolerated.
Self-Abuse: Staff and volunteers are to refrain from substance abuse and any other practice which debilitates the body.
Separation and Divorce: Staff and volunteers are to follow biblical standards of family life. God intends marriage to be a
permanent relationship marked by love, faithfulness and permanence. We believe that Scripture teaches that marriage is
sacred, and is between a man and a woman, and intended until death.
We will respect marriage and work to nurture marriages of staff within our community. In some cases, severe difficulties in
marriage will lead to separation or divorce. We will work with individuals in these circumstances in order to continue to
pursue a godly response in the midst of their situation.
Where a staff applicant has been divorced, Inter-Varsity will determine if he or she has conducted himself or herself in
accordance with Scripture. Since separation and divorce require ongoing support and discretionary judgment, it is
necessary for the Inter-Varsity staff member and volunteer to be under the guidance and authority of his or her church
leadership in making decisions of separation or divorce.
Endorsements: Inter-Varsity staff and volunteers should not in any way espouse, endorse or imply acceptance of any
practice, conduct or attitude which this policy implies or states should be avoided.
Violation and Disciplinary Action: Violation of any of these standards of practice and conduct may result in discipline.
Generally, we will seek recovery and restoration. Most violations will warrant forbearance and patience. Nevertheless, some
violations of the Behavioral Expectations could be considered serious and result in counseling or discipline as appropriate.
Situations involving a serious breach of behaviour including, but not limited to, violence, harassment or illegal activity, will
result in discipline up to and including termination of employment for cause.
Signature
By signing here I affirm I have read and agree with the code of conduct and will abide by the policies.
Signature:_______________________________________
Date: ___________________________________________
Parental Reference Form
To be completed by a family member such as a parent or guardian.
(Applicant’s name) _________________________ has submitted an application to our Leader In Training
program. Will you please fill out this reference form to the best of your ability based on your firsthand
knowledge of the applicant? Your honest opinion is appreciated.
Please check the answers that best apply.
Spiritual Development
Excellent high degree of pursuit and passion
Good
generally pursues growth and passion
Fair
responds with desire when challenged
Poor
shows minimal desire to grow
N/A
no basis for judgment
Leadership
Excellent
Good
Fair
Poor
N/A
Emotional Stability
Excellent exceptionally stable and consistent
Good
well balanced, stable in most situations
Fair
usually balanced between highs and lows
Poor
excitable
depressive
N/A
no basis for judgment
Ability to Follow
Excellent
takes instruction/correction extremely well
Good
generally cooperates with supervisors
Fair
will comply begrudgingly
Poor
can be disrespectful and/or disruptive
N/A
no basis for judgment
Maturity of Judgment
Excellent consistently makes wise and fair decisions
Good
usually makes sound decisions
Fair
inconsistent with good decisions
Poor
hasty
indecisive
N/A
no basis for judgment
Initiative
Excellent
Cooperation
Excellent
Good
Fair
Poor
N/A
Fair
Poor
a leader of leaders
generally influential and positive
will lead when called upon
passive
disruptive
no basis for judgment
looks for things to be done
does what needs to be done
does the obvious, bare minimum
usually needs to be told what to do
Work Ethic
relates very well with others, considerate
usually considerate and sensitive
cooperates when convenient or agreeable
tends to be difficult with others
no basis for judgment
Fair
Poor
N/A
consistently gives extra effort
generally a hard worker
works enough to get by
lazy
no basis for judgment
Teamwork
Excellent
Good
Fair
Poor
N/A
outstanding, joy to work with
contributes positively
neutral, minimal contribution
difficult, often negative contribution
no basis for judgment
Responsibility
Excellent very diligent and dependable
Good
generally follows through well
Fair
follows through when convenient
Poor
needs closer monitoring
N/A
no basis for judgment
Integrity
Excellent
Good
Fair
Poor
N/A
consistently trustworthy
generally honest and true
may obscure the facts
questionable character
no basis for judgment
Creativity
Excellent
Good
Fair
Poor
N/A
ingenious, spontaneously imaginative
holds many creative talents
can do well with help from resources
struggles coming up with ideas
no basis for judgment
Flexibility
Excellent
Good
Fair
Poor
N/A
adapts quickly, remains very positive
generally open minded and adaptable
needs some time to adjust
can get ruffled and upset without routine
no basis for judgment
Ability to Work Under Stress
Excellent thrives, remains pleasant and productive
Good
usually amiable and productive
Fair
survives with moderate success
Poor
tends to get
irritable
panicky
N/A
no basis for judgment
Additional Comments:
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Has the applicant had any kind of difficulty or problem with his/her family relationship that would make
you question his/her effectiveness for this program?
Yes
No
If yes, please describe:
____________________________________________________________________________________
Does the applicant have any kind of personal/social exceptionalities that would limit his/her effectiveness
in this program?
Yes
No
If yes, please describe:
____________________________________________________________________________________
Please comment on your impression of this applicant's relationship with Christ:
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Is there anything else that, in your opinion, affects the suitability of the applicant for this program? :
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Rate your recommendation of the applicant (highly recommend, recommend, recommend with
reservation, cannot recommend):
Comments:
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Signature: ________________________________________________ Date: _____________________
Completed By: _________________________________________________________________________
Relationship to Applicant: _______________________________________________________________
Spiritual Reference Form
To be completed by an adult who knows applicant in a Christian context, such
as a pastor or youth leader. Reference cannot be completed by a family member.
(Applicant’s Name): ________________________ has submitted an application to our Leader In Training
program. Will you please fill out this reference form to the best of your ability based on your firsthand
knowledge of the applicant? Your honest opinion is appreciated.
Please check the answers that best apply.
Spiritual Development
Leadership
passive
no basis for judgment
Emotional Stability
excitable
Ability to Follow
ressive
udgment
Maturity of Judgment
hasty
Initiative
indecisive
Cooperation
Work Ethic
works enough to get by
tends to be difficult with others
no basis for judgment
Teamwork
Responsibility
dependable
gative contribution
Integrity
Flexibility
itive
basis for judgment
In your opinion, does this applicant demonstrate maturity and the potential to work effectively with
children in a camp setting?
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
Please comment on your impression of this applicant's relationship with Christ.
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
Is there anything else that, in your opinion, affects the suitability of the applicant for this program?
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
Rate your recommendation of the applicant (highly recommend, recommend, recommend with
reservation, cannot recommend):
Comments:
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
How long have you known this applicant? ___________________________________________________
In what capacity do you know the applicant? ________________________________________________
Please describe how well you know the applicant:
_____________________________________________________________________________________
_____________________________________________________________________________________
Thank you for taking the time and effort to fill out this reference form. Your statements are
confidential. If necessary, may we contact you for further information? Y / N
Reference name: ______________________________________________________________________
Phone number or email address: __________________________________________________________
Signature (or typed name): ___________________________________________ Date: ____________
To submit this form, please choose one of the following options.
Give to applicant to submit with application
Email to brantford@csranch.ca
Mail to: LIT Coordinator, 1645 Colborne St East, Brantford, ON, N3T 5L4
Fax to Circle Square Ranch: 519-754-5490
LIT Character Reference
To be completed by an adult who knows applicant, such as a teacher, employer, or adult friend.
Reference cannot be completed by a family member.
Name of applicant: _____________________________________________________________________
How long have you known this applicant? ___________________________________________________
In what capacity do you know the applicant? ________________________________________________
Please describe how well you know the applicant:
_____________________________________________________________________________________
_____________________________________________________________________________________
The LIT program at Circle Square Ranch is an intense and demanding experience. The LITs spend two
weeks in training and have an additional week of placement at camp. Please comment on the applicant in
each of the following areas, giving a rating between 1 (poor) and 5 (outstanding) and comment:
Work ethic: 1 2 3 4 5
Comment:
Capacity to work on a team: 1 2 3 4 5
Comment:
Emotional stability: 1 2 3 4 5
Comment:
Physical stamina: 1 2 3 4 5
Comment:
Perseverance: 1 2 3 4 5
Comment:
Teach-ability: 1 2 3 4 5
Comment:
Willingness to respect authority: 1 2 3 4 5
Comment:
Ability to deal with conflict: 1 2 3 4 5
Comment:
Attitude: 1 2 3 4 5
Comment:
Influence on peers: 1 2 3 4 5
Comment:
Willingness to engage new ideas: 1 2 3 4 5
Comment:
Initiative: 1 2 3 4 5
Comment:
Is there anything else that, in your opinion, affects the suitability of the applicant for this program?
In your opinion, does this applicant demonstrate maturity and the potential to work effectively with
children in a camp setting?
Rate your recommendation of the applicant (highly recommend, recommend, recommend with
reservation, cannot recommend):
Comments:
Thank you for taking the time and effort to fill out this reference form. Your statements are
confidential. If necessary, may we contact you for further information? Y / N
Reference name: ______________________________________________________________________
Phone number or email address: __________________________________________________________
Signature: _______________________________________________ Date: _______________________
To submit this form, please choose one of the following options.
Give to applicant to submit with application
Email to brantford@csranch.ca
Mail to: LIT Coordinator, 1645 Colborne St East, Brantford, ON, N3T 5L4
Fax to Circle Square Ranch: 519-754-5490
2016 LIT Application Checklist
Please ensure all of the following are completed with your application (if completing a
paper application):
__ 2016 Brantford Camper Application
__ LIT Supplementary Application
__ LIT Declaration
__ IVCF Statement of Faith
__ IVCF Code of Conduct
__ LIT Parental Reference
__ LIT Spiritual Reference
__ LIT Character Reference
__ Police Check To be submitted before LIT participant can begin placement week.