Explore the Patuxent: Teen Leadership Paddle Application Form
Please complete this form as your application to the 2019 Explore the Patuxent: Teen Leadership Paddle. This program is for students entering 9th-12th grades in Fall 2019.

TEEN PADDLE 2019 IS ONLY ONE SESSION -- July 15 - 19, 2019. The Teen Paddle is limited to 12 openings: 6 for young men, and 6 for young women. Once the openings are filled, applicants will be placed on a wait list.

** Please note**
With your application form, provide the name and email address of ONE reference (a teacher or non-relative). A link will be emailed to that person to provide an online recommendation describing why you are a good candidate for this program. If you are returning for your 2nd year as a camper, your reference will be asked to include examples of how you have used your leadership experience gained through this program.

Those campers returning for a 3rd or 4th year of camp are required to sign a volunteer contract.

Email any questions or concerns to:
Amy Henry (Amy.Henry@maryland.gov)
or call Amy at 410-260-8828 between the hours of 8:30a-4:00p

Applications received by May 1st are eligible for the Early Bird discount camp fee of $250. Friends of Jug Bay members also pay a $250 camp fee. All others pay $300. Scholarships available. Registration closes June 26.

Student's Last Name *
Your answer
Student's First Name *
Please enter first name or preferred name
Your answer
Gender *
Our program does not discriminate on the basis of gender. Please contact Amy with questions
Student's Birthday *
Your answer
Grade (Fall 2019) *
High School *
Your answer
Student email
Your answer
Parent or Guardian *
Please enter both first and last name.
Your answer
Home Address *
Your answer
Home Phone *
Your answer
Work phone
Your answer
Cell phone
please provide parent/Guardian cell phone
Your answer
Parent/ Guardian email *
Your answer
Preferred method of contacting parent/ guardian *
Required
How did you hear about this program? *
Required
How would you describe your swimming ability? *
beginner
expert
Do you feel confident being in the water? *
no confidence
extremely confident
Do you have prior canoeing experience? If yes, please describe. *
Your answer
Name a leader you admire and why. *
Your answer
List 3 characteristics of a good leader. *
Your answer
Please describe a situation in which you were a leader. *
Remember-being a "leader" can be a small or large act!
Your answer
What do you think is the most important issue concerning the Chesapeake Bay today? *
Your answer
How have you been an advocate for any local environmental issues? *
Again, think big or small!
Your answer
Almost done -- We need the name and email address of someone (teacher or non-family member) for your recommendation.
Reference Name (first and last) *
Your answer
Reference email (they will receive a link to the online form) *
Your answer
Submit
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