- First Name: *
- Last Name: *
- Address: *
- City: *
- State: *
- Zip: *
- Cell Phone:
- Email: *
- Confirm Email: *
- What pronouns do you use for yourself?:
NOTE: Due to the College’s housing system, we must house people in the male/female gender binary. Please indicate with which gender you feel the most comfortable being housed.
- With which gender group would you feel most comfortable being housed?:
- female male
- Birthdate: *
- What grade are you about to enter?: *
- Please describe physical accessibilty needs, if any::
- Food preference - check all that apply: *
- List any medications you are currently taking::
- Please list allergies, if any (If NONE, leave BLANK)::
- Other allergies or considerations you would like us to be aware of?:
- T-shirt Size: *
- Congregation: *
If financial assistance in the form of a scholarship of up to $150 could make the difference in your ability to attend, please check the box to complete an application process.
- SCHOLARSHIP: *
- Yes I'd like to request a scholarshipNo
The undersigned hereby authorizes or ratifies MidWest Leadership School (MWLS) and/or Youth MWLS (YMWLS), their agents or employees, to use my photographic/video images for purposes of publicity and other promotional, non-profit uses.
This consent extends to the editing of the images to the extent necessary for normal production purposes, provided that the intent of the images is not altered.
This consent shall act to expressly release from liability MWLS/YMWLS and the component parts as well as its employees. The meaning and purpose of this consent has been fully explained to me.
If I consent, I will type my signature in this box. If I do NOT consent, I will type DO NOT AUTHORIZE.
- Photo release signature: *
- Parent or Guardian Name: *
- Parent or Guardian Phone: *
- Parent Alternate Phone:
- Parent or Guardian Email: *
- How did you hear about MWLS? (Check all that apply.):
- Word of mouth
MWLS or other website
Poster at Church
Please tell us your plans for payment.
Remember, the applicant's $200 deposit is non-refundable and refunds for cancellation are considered on a case-by-case basis.
- Please choose one.:
- I will pay the full tuition, and my congregation will pay the congregational fees
I will pay partial tuition, and my congregation will pay the remainder of the tuition plus the congregational fees
My congregation is paying my full tuition plus the congregation fees
RULE 1. No smoking, tobacco products, illegal drugs, or alcohol.
This will be a tobacco and alcohol-free week for all participants, including staff. It is not OK to possess or use any tobacco, alcohol or drug products on site or nearby at any time during the week.
YOUTH MWLS RULES:
Checking the box next to each rule indicates you have read and agree to abide by that rule.
- I will abide by rule 1.: *
RULE 2. No sexual behavior.
Although sexuality is something to be valued and developed in persons of all ages, Youth MWLS is not the place for exploring or engaging in any sexualized behavior. The variance in readiness for sexual relationships among young people can make sexual activity at group events awkward, difficult and harmful. Any sexual or sexualized behavior by participants of any age detracts from our goal of healthy community and full inclusiveness. No sharing beds, and shirts will remain on at all times! Sexualized activity will result in youth being sent home.
- I will abide by rule 2.: *
RULE 3. No weapons, fireworks, or explosives.
- I will abide by rule 3.: *
- I will abide by rule 4.: *
- I will abide by rule 5.: *
RULE 5. I will stay on site.
You are expected to stay on site during the week. Exceptions are made only for emergencies and with explicit permission and notification of a staff member.
RULE 6. I will abide by the rules.
I will abide by the rules of the site and the laws of the city and state in which the school is located.
- I will abide by rule 6.: *
RULE 7. I will model self-care by respecting myself, recognizing my physical (sleep!), emotional, and psychological needs, and seeking appropriate allies and professionals (when needed) with whom to process my feelings and concerns.
- I will abide by rule 7.: *
RULE 8. I will manage my time in order to honor my need for physical and spiritual renewal so that my needs do not interrupt or undermine my part in this faith community.
- I will abide by rule 8.: *
- I will abide by rule 9.: *
RULE 9. I will contribute to the community being created at the school by actively pursuing my own faith development and enrichment.
RULE 10. I will be a responsible representative of the Unitarian Universalists. I understand that the writings, photographs and video I share publicly about Youth Midwest Leadership School need to be appropriate and not obscene or violent in any way.
- I will abide by rule 10.: *
- Whose name is on the check or credit card you're paying with?: *
- Person being registered
- Enter the Security Code: *
- I agree to the terms and conditions: *