Request edit access
                       Inclusive Louisiana                                               hosts Rural Roots Louisiana (RRLA)                      NEXTGen Summer Camp Application  2026 
Email *
*
Potential Camper's Full Name:
 *
Potential Camper's email address:
 *
Potential Camper's telephone number:
 *
T-Shirt Size:
 *
Parent/Gaurdian's Name:
 *
Parent/Guardian's Email Address:
 *
Parent/Guardian's Telephone Number (Best no.): *
Rising Grade Level (Fall 2026):
 *
Emergency Contact Name (Other than Primary Guardian): *
Select the Camp Session, Your Child Will Attend: *
Required
Please describe any known medical conditions or allergies (including food allergies) that the camp staff should be aware of: *
Will your child need transportation to and from camp?  Please reply Yes or No. *
In order to attend NEXTGEN Summer Camp 2026 we must have a signed Media Release Authorization:
Do you authorize the use of your child's photo/video for camp promotional materials?
 *
What are the current interest of the camper  *
Required
We have morning prayer and may cover a scripture, we say grace for lunch, and may say a prayer before dismissal. Can your child participate? Type your name. *
How did you hear about the NextGen Summer Camp?* *
Why do you want to be a part of the NextGen Summer Program?* *

Inclusive Louisiana host RRLA NextGen Summer Camp 

Code of Ethics 

The Inclusive Louisiana host RRLA NextGen Summer Camp is dedicated to fostering a community of youth leaders committed to environmental justice, civic engagement, and personal growth. As a participant in this program, each student, staff member, and volunteer is expected to uphold the following ethical principles and values throughout the duration of the camp and beyond. 

1. Respect for All 

Treat all peers, staff, guest speakers, and community members with kindness, dignity, and fairness. 

Embrace diversity in all forms—race, gender identity, religion, socioeconomic background, and personal beliefs. 

Use respectful language and behavior at all times. 

2. Responsibility and Accountability 

Arrive on time, prepared, and ready to engage every day. 

Take ownership of your actions and choices—both positive and negative. 

Follow all camp rules, safety guidelines, and staff instructions. 

3. Integrity and Honesty 

Be truthful in all interactions and communications. 

Give credit to others when using ideas or work that is not your own. 

Report unsafe or unethical behavior to a staff member. 

4. Leadership Through Service 

Lead by example in your behavior, work ethic, and attitude. 

Seek ways to serve and uplift your community and fellow campers. 

Approach challenges with a growth mindset and a willingness to learn. 

5. Commitment to Learning 

Participate fully in all activities, regardless of the topic or format. 

Stay open-minded and curious about new ideas and perspectives. 

Use the skills and knowledge gained to create real impact in your community. 

6. Environmental Stewardship 

Respect the earth and understand the importance of environmental justice. 

Take care of your surroundings and reduce waste whenever possible. 

Promote sustainable habits in your personal and community life. 

7. Appropriate Use of Technology 

Use digital devices only when permitted and for educational purposes. 

Avoid cyberbullying, inappropriate content, or disruptive online behavior. 

Protect your privacy and that of others. 

8. Commitment to the Program 

Attend all four (4) weeks of camp as agreed. 

Remain engaged and present during all camp sessions. 

Support a positive, encouraging environment for everyone involved. 

Shape 

Acknowledgment 

By participating in Inclusive Louisiana host RRLA NextGen Summer Camp, I agree to uphold this Code of Ethics and contribute to a safe, inclusive, and empowering space for learning, leadership, and growth. I understand that failure to follow this code may result in disciplinary action, including possible removal from the program. By Parent and student typing your name below you are agreeing.

 *
Rural Roots Louisiana (RRLA), Inclusive Louisiana (il), Louisiana Bucket Brigade (LABB)
Liability and Hold Harmless Agreement
This form serves as a Liability and Hold Harmless Agreement for participants of the Inclusive Louisiana host NextGen Summer Camp located at The Hub of Inclusive Louisiana, 8111 Romeville Street, Convent, LA, St. James Parish.
By signing this form, the student and parent/guardian acknowledge and agree that Rural Roots Louisiana, Louisiana Bucket Brigade, and Inclusive Louisiana--the sponsors and organizers of this program--are not and will not be held liable for any accidents, injuries, or incidents that may occur during the course of participation in the camp. This includes , but is not limited to, activies such as bike riding, car transportation, walking, physical movement, or falls. 
No horse playing or unsafe behavior is allowed. Any violation of safety rules may result in removal from specific activities or the program. 
By acknowledging below, the student and parent/guardian release and hold harmless the sponsors from any claims or liabilities arising out of participation in camp-related activities. 
 *
Agreement to Camp Policies and Release of Liability*

 *
Typing your name below is acknowledging that you have read the application in its entirety and agree with the above statements.  *
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms