American Dream Mall Chaperone Application

Chai Lifeline Canada’s annual American Dream Mall trip will be held from Feb 26 – Feb 29, 2024 The trip will include 20 Chai Lifeline Canada young boys who are siblings of a Chai Lifeline client. 3 Chai Lifeline Canada staff will be joining and leading the program.

About the opportunity:

Chaperones will function as a Camp Counsellor, responsible for 2 campers throughout the day and evening.
Days begin at 9 AM, concluding at 9 PM. Assistance with helping campers change into their clothing might be required.
Assistance with bathing and washrooms are NOT required.
Chaperones will have their own beds, but share a room with 2 campers in bunk beds.
Chaperones will be required to accompany campers to all events, assist other councilors or staff if help is needed.
All activities will be organized and paid for by Chai Lifeline Canada and will be done together as a group.
Cell phone use during the day for personal use is not permitted.
All chaperones will be required to return home with their campers – no permission will be granted for any staff to remain behind in the United States.

Please note that all chaperone applicants will be interviewed by our Chai Lifeline Canada staff.

Chaperone Application
Please fill out the required fields and attach your resume.
Legal Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Phone*
Email*
Post Secondary Institution? {If Applicable}
Experience; Academic & Other {extra curricular}
How did you hear about this opportunity?*
Name of Person?
CPR/First Aid Certification*
- Yes
- No
NLS Certification -*
- Yes
- No
Are you currently a Chai Lifeline Volunteer? If so, in what capacity?*
Have you worked with children before? Please provide details.*
Why do you want to be a chaperone on the Chai Lifeline Canada Edmonton Trip?*
What are 3 characteristics that make you a great role model for children and youth?*
As a chaperone, what would you contribute to the kids experience? What would you contribute to the staff as a chaperone?*
List and describe any skills you have that would be relevant to being a chaperone in a large group setting with young kids?*
References
Please submit the names and phone numbers of TWO adult references who can speak to your work ethic.
First Reference Name*
First Last
First Reference Email Address*
First Reference Phone Number*
Second Reference Name*
First Last
Second Reference Email Address*
Is there anything else you'd like us to know about you?
Upload your resume*
Drop files here or

Max. file size: 256 MB.
Please upload a copy of a valid government issued photo identification*
Max. file size: 256 MB.
* Not all applicants are guaranteed acceptance. Identification is being taken during application process to expedite travel booking.
Signature*
Use your mouse or finger to draw your signature above

Chaperone Application

References