APPLICATION PACKET
Oakland Rotary Enterprise Institute
A Camp for the Business Leaders of Tomorrow
Friday, April 4 – Sunday, April 6, 2014
Deadline to apply: Friday, January 31, 2014
1. Read the entire application packet before completing your application.
2. Fill out the application legibly.
3. Ask your parent (or guardian) to read the application packet and sign the completed copy of
your application.
5. Give the application to your school counselor or other person designated at your school and
we will come and pick it up from them. Or send in your application to Oakland Rotary Attention:
Bob Barth, 1736 Franklin St., Suite 200, Oakland, CA 94612. Or Email your completed application
to Bob Barth, goodbob46@hotmail.com. Please adhere to the deadline of 5pm, January 31,
2014.
Please Note: APPLICATIONS WILL NOT BE ACCEPTED AFTER DEADLINE.
The mission of Oakland Rotary Enterprise Institute is to enhance leadership skills of
outstanding high school Juniors through a working introduction to the
opportunities, benefits and challenges of establishing and operating a business or
providing services in our business community.
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“Not only did I meet some wonderful new people and make a number of new friends but I also learned a lot. I gained a
much better perspective of what I might want to do in the business world, as well as what I want to study in college.
Once again, thanks for everything. It was an experience I will never forget.”
Comment of a past student participant
WHO IS ELIGIBLE?
• High School Juniors that are enrolled in a public, private or charter school in Oakland, Piedmont or Emeryville.
WHAT DOES THE Enterprise Institute INCLUDE?
• Dynamic keynote address with a motivational message from a local business leader.
• Interactive training and presentations by acknowledged experts on presentation skills and business concepts.
• Working in a team to review challenges and opportunities that real businesses face and then develop and
then, as a team, present solutions to the problems that were outlined. Enterprise Institute attendees are
grouped into several working teams. Each team has a Rotarian coach (Discussion Group Leader) and a Peer
Counselor, who is a student that was an outstanding participant in the previous year’s conference.
• “Hands-on” team activities building collaboration, presentation, and business skills.
• Competitive team presentations of a business plan that demonstrates creative and collaborative skills and an
understanding of business concepts. The winning team members will receive prizes and will be featured on
the Oakland Rotary’s website.
• A Talent Show on Saturday night.
 Free time for recreational activities in a beautiful setting in the Redwoods outside Aptos, CA.
• All meals, bus transportation to and from the camp venue – Camp Monte Toyon in Aptos California - lodging
for the entire program, as well as group snacks. The program is entirely FREE to schools and
participants.
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IF YOU ARE ACCEPTED/INVITED TO ATTEND
YOUR IMMEDIATE ACCEPTANCE - Students who are accepted will receive an email Invitation and Acceptance
message/letter. You should reply by email as soon as possible, but no later than March 18, 2014. If you accept
but later discover you cannot attend, immediately contact Bob Barth to release the space for an alternate
student. Bob Barth can be reached at (415) 632-6801 or Email: goodbob46@hotmail.com.
REGISTRATION and ATTENDANCE – Registration will be on Friday, April 4th, between 7:30 – 8:00 AM at the
Oakland Rotary Club, 1736 Franklin St., Suite 200, Oakland. The buses will leave for Camp Monte Toyon, Aptos,
CA immediately after the registration. Students are expected to attend all scheduled sessions of the Enterprise
Institute and their team meetings. Being on time and prepared to participate with peers is a sign of respect for
the team, the Enterprise Institute and your Discussion Group Leader, a Rotary volunteer. A student may not leave
camp early. The only exception is for a medical emergency.
CLOSED CAMPUS - Once signed in at the Enterprise Institute, a student may not leave unless signed-out by Bob
Barth, the Enterprise Institute Chair, prior to being picked up by a parent/guardian with appropriate
identification. There is no cell phone service at the camp and there is very limited WIFI only in certain areas.
ROTARY TRANSPORTATION - All students, once signed into the Enterprise Institute, must use Rotary-provided
transportation to and from the venue. Transportation is by charter bus. Under no circumstances is the use of
personal vehicles of parents, students or friends acceptable.
NOTIFICATION OF SPECIAL NEEDS/MEALS - Physical limitations requiring special accommodations or special
medical dietary needs should be included in your application so that Rotary might provide the necessary
accommodations at the venue. All of the meals will have a vegetarian option.
MEDICATIONS, ALCOHOL & WEAPONS POLICY - Any medication, whether prescribed or over-the-counter, must
be fully identified on its container. The student must inform their Discussion Group Leader of the need to take
medicine. Students may not have in their possession or in their rooms any unapproved medicine or
alcohol/wine/beer or other controlled items, or any weapons. A student who confronted by another student with
any of these items or any other dangerous practice, is required to seek out adult help (usually their Discussion
Group Leader) in distancing him/herself from the situation.
PARTICIPATION AND CONDUCT - The end of each day may vary, but “lights out” and sleep time are strictly
supervised and enforced. Any participant disturbing the group or other venue guests (the public) will be subject
to disciplinary action requiring parents/guardians to pick them up immediately. Participants are expected to
conduct themselves so as to bring credit to themselves, their school, their parents/guardians and Rotary.
Violation of these rules may result in termination of participation in conference activities at any time, day or
night.
WHAT PARTICIPANTS SHOULD BRING!
An open, inquisitive, and creative mind and a winning attitude
Personal toiletries, necessary medications, face and bath towels, hair dryers, soap, flashlight, sleeping bag or
blankets, pillows, toothbrush & toothpaste, comb, and other grooming products
Comfortable casual clothes & shoes for the working sessions at the conference
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For the talent show, musical instruments, the size of a guitar or smaller, are encouraged to be brought, if you
would like to play them as part of your presentation. A piano is available at the Camp.
Note: Pens, pencils, and binders and other materials such as flip charts, markers, and tape are provided.
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Oakland Rotary Enterprise Institute
APPLICATION FORM
Name
Gender
M
School
Address (Home)
City
State
Phone (Home)
Phone (Cell)
Email
Primary Parent/Guardian
Secondary Contact
Name
Relationship
Phone Contact #1
Phone Contact #2
MEDICAL CARE INFORMATION
MEDICAL INSURANCE PROVIDER
POLICY NUMBER
The applicant does not currently have medical insurance
Please list any medications the applicant would need to take while at the Conference
Medication Name
Frequency Taken
Please list any allergies the applicant has
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F
Special Needs or Dietary Requirements
AUTHORIZATION, CONSENT & RELEASE FORM
This authorization and release pertains to the Oakland Rotary Enterprise (ORE) taking place between with my signature, I hereby:
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AUTHORIZATION, CONSENT & RELEASE FORM
This authorization and release pertains to the Oakland Rotary Enterprise Institute taking place between April 4-6, 2014.
With my signature, I hereby:
1. Confirm that I have received, read and understood the contents of the Rotary Expectations of Accepted Students and that the
information provided in this application is accurate at the time of signature.
2. Confirm that I have read the entire Oakland Rotary Enterprise Institute Application Packet (all nine pages) and understand the
nature of the Enterprise Institute experience, the Enterprise Institute Rules and Regulations and the requirements for an applicants’
participation.
3. Confirm that I am available to participate on all of the stated dates for the Oakland Rotary Enterprise Institute.
4. Confirm that I am now a high school junior in credits and expects to be a high school senior in the fall following the event.
5. Grant to The Oakland Rotary Club (ORC) permission to copyright, use, reuse, publish and republish any photograph/video taken of
the student by the ORC or those commissioned by the ORC. This right applies to any reproductions in any form, used alone, in a
composite or with any printed matter or advertising copy, for any purposes of trade, advertising, publicity, promotion or education,
without restrictions or limitations. We release the ORC and its agents from liability resulting from any distortion, blurring, alteration,
optical illusion or placement in a composite, intentional or otherwise, which may occur in the taking, processing, reproduction,
publication or distribution of such image(s). I waive the right to approve the image(s) or use. I have read this agreement and release
all liability and understand the terms.
6. Grant to The ORC permission to share my student’s e-mail address with other event participants for the purposes of preparation
and team building. I understand that this information will not be sold or used in relation to any commercial activity.
7. Acknowledge the requirement to attend the Orientation session and agree to do so.
STUDENT CONSENT AND WAIVER
With my signature, I hereby:
1. Acknowledge and agree to the points outlined above.
2. Confirm that I will abide by the rules and expectations of the Oakland Rotary Enterprise Institute, including conducting myself in a
manner that will bring positive credit to my school, my parents/guardians, the sponsoring ORC and me.
3. Agree that once I am signed into the Oakland Rotary Enterprise Institute, I will not leave without the permission of the Oakland
Rotary Enterprise Institute Chairman and the permission of my parents/guardians.
________________________________________________________
Student Signature
________________________________
Date
PARENT/GUARDIAN CONSENT AND WAIVER
With my signature, I hereby:
1. Acknowledge and agree to the points stated above.
2. Confirm that I am the legal parent/guardian of the applicant, and that I am listed as the primary contact in this application.
3. Authorize, in the event of emergency, the bearer of this form to request, obtain, contact, or direct the provision of medical care
for the named, student should this be necessary during the period of the Oakland Rotary Enterprise Institute activities. I accept all
financial responsibility for such medical care as may be rendered.
4. Consent and grant the applicant permission to attend Oakland Rotary Enterprise Institute and be transported by Oakland Rotary
provided transportation during the aforementioned dates.
5. In consideration of the selection of said student for participation in the Conference activities and the education, training,
recreation and fellowship afforded thereby, I, for myself, heirs, executors, administrators, and assigns, hereby waive and release all
rights and claims against the Oakland Rotary Club, their officers, agents, employees, representatives, members, successors, and
assigns for any damages or injuries which may be sustained by said student in connection with or for participation in the Oakland
Rotary Enterprise Institute.
__________________________________________________________
Primary Parent/Guardian Signature
____________________________________
Date
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The Following Information Should be Completed by the Applicant/Student
Why are you interested in applying to attend the Oakland Rotary Enterprise Institute?
Provide an example of a situation in which you provided leadership, what you learned about yourself and
leadership through the experience, and how you might use that knowledge in the future.
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In ten years, what do you see yourself doing?
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