APPLICATION FOR YOUTH COUNCIL, 2018-2019 SEASON

 

 

Thursdays, 6:00 to 8:00 pm
September 27, 2018 to May 2, 2019.
FREE

 

The Youth Council is an engaging group of active teens between the ages of 14 and 19 who produce cultural activities relevant to Museum London’s programming. Through art and artistic processes, participants gain hands-on experience that is creative, socially conscious and practical, while developing valuable leadership skills. Are you a curious teen who wants to learn about art, work with artists, visit nearby galleries, host events and receive volunteers hours for your work? Then the Council is the place for you!

 

Applications are reviewed and candidates are notified of their acceptance by early September. Members are asked to commit to meetings from September through May. To learn about our past activities, visit our Facebook Page. 

 

 

https://www.facebook.com/MuseumLondon#!/MuseumLondonYouth?fref=ts

 

Contact Information

Country*
State / Province*
Address*
City*
*
*
*
*
*
*
Email*
Confirm Email*
Phone*

Parent/Guardian Information

Parent/Guardian #1 Name *
Parent/Guardian #1 Address (if different than above) *
Parent/Guardian #1 Phone *
Parent/Guardian #1 Cell
Parent/Guardian #1 Email
Parent/Guardian #2 Name
Parent/Guardian #2 Address
Parent/Guardian #2 Phone
Parent/Guardian #2 Cell
Parent/Guardian #2 Email
Permissions
  • I hereby give my permission to occassionally photograph/videotape my child during activities for Museum's promotional purposes

I understand that class activities have an inherent risk factor and that all appropriate precautions will be taken for participant safety. I agree to not hold Museum London, or any of its employees responsible in the event of an injury to my child.

I hereby certify that all information completed in this form is accurate and up to date. I will contact the staff promptly, in writing, if any changes occur in the participant’s health status between now and arrival at the program, as well as during the program.

 
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  • I have read the above and understand the terms.

Emergency Contact #1 Information

Emergency Contact #1 Name *
Emergency Contact #1 - Address*
Emergency Contact #1 - Relationship to you *
Emergency Contact #1 - Telephone
Emergency Contact #1 - Cell

Emergency Contact #2 Information

Emergency Contact #2 - Name
Emergency Contact #2 - Address
Emergency Contact #2 - Relationship to you
Emergency Contact #2 - Telephone
Emergency Contact #2 - Cell

Health Questions

Allergies
  • Drugs
  • Food
  • Insect Stings or Bites
  • Seasonal Allergies (i.e. Hay Fever)
  • Other
  • Reactions
  • Carries an Ana Kit
  • Carries an Epi Pen
Please note any recent illness, operations or injuries:
Please note if under any form of treatment/medication for any illness, condition, or injury
  • Yes
  • No
If answered yes above, please explain
Willl this condition limit or affect your participation in activities?
  • Yes
  • No
Other Health Issues:
  • Asthma
  • Hypertension
  • Seizure Disorders
  • Diabetes
  • Hearing Difficulties
  • Vision Difficulties
  • Emotional/Physical LImitations
  • Frequent Colds/Sinus Trouble
  • Hearing Aids
  • Use of Prosthetics/Aids
  • Heart Disease/Defect
  • Clotting Disorders
  • Headaches
  • Behavioural Concerns
  • Skin Conditions
  • Urinary Tract Infection
  • Eating Disorders

Questionnaire

Please describe why you want to join the Youth Council and what you hope to gain from the experience.
Please list previous volunteer experience including location, commitment length and duties.
What are some of your interests and skills?
Extracurricular Activities
Volunteer Hours?
  • Yes (40 Hours)
  • Yes (40 + hours)
  • No

Security Code