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Leadership and Creativity Game Camp
Leadership and Creativity Game Camp
Name
First
Middle
Last
Gender
Male
Female
Age
Grade
Date of Birth
MM slash DD slash YYYY
School
Address
*
Street Address
City
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Phone (home)
*
Phone (other)
Email
Duration (9:00am-4:30pm)
Week 1 - $175
Week 2 - $175
Week 3 - $175
Week 4 - $175
Day fees - $45
Registration Fee (Mandatory) - $45
Virtual Reality Headset -$45
Please note that spaces are limited and registration for only the first week will not guarantee a space for the second or third week. Thus parents/guardians are encouraged to register for the duration of the programme from the onset.
Orientation Interview
Interview Date
MM slash DD slash YYYY
Interview Time
:
Hours
Minutes
AM
PM
AM/PM
Indicate programme details
Scholarship
Partial Scholarship
No Scholarship
Order a Tshirt?
*
No
Yes
T-shirt
Quantity
Price:
$45.00
Quantity
Size
Small
Medium
Large
Xl
XXL
State interests
State any special needs
Parent/Guardian Name(s):
*
Participant's medical disclosure:
Does your child/ward suffer from any known illnesses or allergies?
*
No
Yes
illnesses or allergies
Waivers and Informed Consent:
*
I agree.
By completing this form, I, as parent/guardian, permit JOIE Innovative Learning Solutions to use pictures of my child(ren) as a program participant in promotional literature, videos, and the JOIE website. I understand my child(ren)'s name(s) will not be published.
RELEASE, INDEMNIFICATION AND PROMISE NOT TO SUE
I hereby indemnify, hold harmless and release JOIE Innovative Learning Solutions, its shareholders, directors, officials, representatives, agents and employees from any and all loss, claims, damage, or liability which might arise out of my child(ren)'s involvement in any scheduled activities.
CAPTCHA
Payment Method (cash, bank deposit, cheque)
NB: Full payments are due upon the first day of the program. Any cancellations of attendance made less than 48 hours before the first day of the program will result in forfeit of the full payment as compensation for the space that was held.
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Contact Info
John Compton Highway, upstairs Dr. Scotland’s Veterinary Clinic.
Address Line 1
+1 758-728-8248
info.joie758@gmail.com