Eab participant application winter spring 2015
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Transcript of Eab participant application winter spring 2015
Revolution(s) BMX Earn-A-Bike Youth Participant Application: Winter/Spring 2015
Page 1
Overview
Revolution(s) is a program of Youth Unlimited (Toronto YFC), a Christian faith-based
organization. The goal of Revolution(s) is to foster a community of young leaders; to discover
purpose & passion, the value of service and a healthy way of life. Part of a healthy life includes
developing positive relationships with peers, and mentoring relationships with caring adults.
The Revolution(s) Earn-A-Bike program will take place Friday afternoons from 4-6pm,
February 27th – May 29th, 2015. The program will include discussion on character
development and instruction on bicycle assembly and maintenance. Youth will be learning
basic bicycle mechanics through refurbishing old bicycles for the community. Youth who
complete all parts of the program will earn a bicycle for themselves.
Commitment from the Youth Participant is as follows:
If accepted as a participant in the Revolution(s) Earn-A-Bike program you must
accumulate a minimum of 24 credits throughout the length of the program (one credit is
given for every hour of learning and repair logged) Adequate participation in the program,
determined by the instructors and leaders of Revolution(s), will EARN you the bike or
community service hours. The bike earned cannot be sold for one year after completing the
Earn-A-Bike program, unless approved by Revolution(s) staff.
Revolution(s)’s Three “R’s” Code of Conduct
Respect: Respect for yourself and others
CaRe: Taking care of your and others’ property
EnviRonment: Maintaining the good state of your surroundings
For more information please contact
Clement Lee: 416-508-7355 // [email protected] or Jesse James: 647-835-8062 // [email protected]
Revolution(s) BMX Earn-A-Bike Youth Participant Application: Winter/Spring 2015
Page 2
Revolution(s) BMX Earn-A-Bike Youth Participant
Application: Winter/Spring 2015
Participant’s Name: _____________________________________ Age: ________
Date of birth: _____________________
Street: _________________________________________ City: __________________
Apartment #: __________________ Postal Code: _____________________________
Phone Number: ( ______ ) _________-_____________
Social Media Contact info (facebook, twitter, instagram, etc.): ___________________
______________________________________________________________________
Parent/Guardian’s Name: _______________________________________________ Parent/Guardian’s contact number: (_______) _____________-________________ Please answer all following questions as honestly as possible – we aren’t looking for the ‘right’ answer, we just want to know more about you!
How did you hear about Revolution(s)’s Earn-A-Bike program?
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Revolution(s) BMX Earn-A-Bike Youth Participant Application: Winter/Spring 2015
Page 3
Why you are interested in being a youth participant in the Earn-A-Bike program?
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Do you already have a BMX bike, whether new or old?
(YES) (NO)
If (NO), you will be receiving a new BMX bike, sponsored in part by Silent Sports and Norco BMX . The make and model of the bike will be determined before each BMX Earn-A-Bike program begins, but may be different for each group of youth that participate.
If (YES), you have a choice: donate the bike back to Revolution(s) to be used as a teaching tool for other youth and receive instead community service hours equivalent to the hours spent in class. Or, you may trade in your current bike for the new bike from Revolution(s), allowing your previously owned bike to be a teaching tool for other youth participants.
Commitments
If accepted as a participant in the Revolution(s) BMX Earn-A-Bike program you must commit to
accumulating 24 credits on bicycle repair during the period of February 27th – May 29th. Adequate
participation in the program and accumulation of credits, as determined by the instructor and
leaders of Revolution(s), will EARN you the BMX bike or the community service hours. The BMX bike
earned cannot be sold for one year after completing the program, unless approved by Revolution(s).
Revolution(s)’s Three “R’s” Code of Conduct
Respect: Respect for yourself and others CaRe: Taking care of your and others’ property EnviRonment: Maintaining the good state of your surroundings
Revolution(s) BMX Earn-A-Bike Youth Participant Application: Winter/Spring 2015
Page 4
I (youth’s name) ___________________________________ will…
� treat myself and others with dignity, fairness, and respect at all times, and
especially when there is a disagreement by demonstrating honesty and
integrity;
� show proper care and regard for Revolution(s)’s property and for the
property of others, especially other Revolution(s) participants, leaders,
volunteers, and sponsors;
� respect the need of others to work in an environment of learning and
teaching, and caring for that environment by maintaining a high level of
cleanliness and orderliness
� respect persons who are in a position of authority;
� … and I affirm, with my signature below, that I will follow Revolution(s)’s
Code of Conduct and that I understand Revolution(s) is a program of Youth
Unlimited (Toronto YFC), a Christian faith-based organization. If, through
appropriate means, it is decided that I have not followed through on my
commitment to uphold Revolution(s)’s Code of Conduct then I understand
that my participation in the Revolution(s) BMX Earn-A-Bike program will be
stopped, and I will not complete the program and will, thereby, not earn or
receive the BMX bike.
Youth Participant’s Signature: _____________________________________________
Date Signed: ______________
Parent/Guardian’s Signature: _____________________________________________
Date Signed: ______________
Revolution(s) BMX Earn-A-Bike Youth Participant Application: Winter/Spring 2015
Page 5
To submit a completed Youth Participant application for Revolution(s)’s BMX Earn-A-Bike program:
1. Mail it to: Attn: Clement Lee at Spring Garden Church
112 Spring Garden Ave.
Willowdale, ON
M2N3G3
2. Or hand-deliver it to the Youth Unlimited office @ Spring Garden Church (address above)
Applications must be received by February 21st, 2015.