LEAPYEAR 2018 Program - February - August 2018 Packet I-Acceptance & Registration - LEAPNOW
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LEAPYEAR 2018 Program February – August 2018 Packet I--Acceptance & Registration (10/19/2017 revision) LEAPNOW is happy to invite you to participate in our 28th LEAPYEAR group! This packet will give you program information, and let you know what you need to do to register and prepare for your journey. As you consider whether to do LEAPYEAR, keep in mind that LEAPYEAR is the only full year program we know of that is designed to meet the developmental needs of young adults navigating the transition from high school to college, from home to independence, and from late adolescence into adulthood. We don’t know any other program that brings together group travel, solo internships, inner-directed retreats, rites of passage, conscious community and fully integrated undergraduate credit and financial aid. LEAPYEAR is meant to challenge you – culturally, physically, emotionally, mentally, socially and spiritually. These challenges are for young men and women who wish to live as deeply and richly as possible. We expect you to lean forward into the myriad experiences that are offered, rather than running from them. When things get tough, we work through them, which intensifies the learning. If you are not willing to challenge your boundaries & limitations, relate positively with a group, work hard, learn another language, meet other cultures & participate fully, please do not register for this program! Each year people start LEAPNOW programs without having read critical information or disclosed critical information. Before you decide that you will definitely do the program, please read through this entire packet so that you know what you are committing yourself to. Our staff is available to address any question, need, or special concern that you may have between now and the start date. LEAPYEAR is a major undertaking, and though we endeavor to make our information packets as clear and comprehensive as possible, questions inevitably arise, so please don’t hesitate to contact us when you need assistance or advice. If you decide NOT to do the program, please let us know. Our small group size and great student to staff ratio (6:1 while traveling and 3:1 on retreats) allows us to provide a high degree of individual attention. Over the years, we have resisted the inevitable urge to increase the size of our program – capping overall group size for this group at 33 students (working with 8 full-time staff and 4 interns) to ensure a very personalized LEAPNOW journey. We believe that the growing edge of our own consciousness is the best place to live - that’s where we plan to be during this coming year. Someone said, “Go out on a limb, that’s where the fruit is.” We invite you to join us “out here” on the growing edge! Enthusiastically yours, Cassie Bull, LEAPNOW Co-Founder & Co-Director Rebecca Carrillo, Director of Admissions LEAPNOW: Transforming Education 11640 Highway 128, Calistoga, CA 94515 USA Phone: 707-431-7265 Fax: 707-431-8479 Email: firstname.lastname@example.org Website: www.leapnow.org
LEAPYEAR 2018: Packet I— Acceptance and Registration Packet Page 2 LEAPYEAR SPECIFICS Program Registration: Please do the following to guarantee your space in the program. If you are confused about any aspect of the program, don't stay that way - call us! 1. MOST IMPORTANT: Before you do anything else, sit down and read this entire packet! Then decide if you TRULY want to do the program. It is critical that you know what you are getting into BEFORE you sign or pay anything. 2. Pay your confirmation fee to Naropa University and submit your registration packet to LEAPNOW. Please note these are two different offices in different locations! Contact information for each office can be found at the end of the registration packet. Please make a copy of the registration packet for your records. 3. The packet in your hands is Packet I—Acceptance and Registration Packet. Once the confirmation fee is paid and paperwork received, we can guarantee your space in the program, and we will send you three further packets to prepare you for the program: Packet II—Logistical Preparation has information about communication, safety, travel details, financial aid, health insurance, immunizations, visas, gear & equipment packing lists. Packet III—Academic and Mental Readiness is devoted to academic preparation, college credit, guidance on choosing an internship, and things that students can do to mentally prepare to embark on their LEAPYEAR journey. This will include simple and relevant assignments you must complete before your year begins. LEAPYEAR Parent Packet is a packet for parents and prepares them for the transitions that lie ahead with their child as well as for the Rite of Passage ceremony. 2018 Program Dates: Feb. 6 – Feb. 13, 2018 First Retreat Feb. 14 – April 15 Group Travel – Nepal/India or Latin America April 16 – April 23 Second Retreat April 24 – May 10 At Home – Curriculum Continues May 11 – May 31 Third Retreat May 26 – May 27 Rite of Passage Weekend - with Parents June 1 – Aug. 13 Individual Internship Aug. 14 – Aug. 22 Fourth Retreat Program Fee: The cost for the LEAPYEAR 2018 program is $34,900. This includes a fully integrated year of undergraduate tuition at Naropa University. (If you were to pay for this credit separately, the tuition alone would cost over $25,000.) The LEAPYEAR program fee also includes all food and lodging during the 8 months of the program, all scheduled program activities, one additional internship placement for study and work abroad in the year following program completion, and the annual reunion retreats. The payment process is detailed in the Student Registration and Tuition Agreement. For support in paying for LEAPYEAR, please visit the Tuition and Financial Aid page on our website: www.leapnow.org/leapyear/tuition.php
LEAPYEAR 2018: Packet I— Acceptance and Registration Packet Page 3 Individual Internship: Your LEAPYEAR tuition includes a budget of $2,500 per person for the10 weeks of the Second Semester Individual Internship. Most past LEAPYEAR participants have been able to stay within this budget. This is a reasonable ($250/week) cost for volunteer placements in most parts of the world. Internship airfare is variable, averaging about $1300, but can range from $0 to $2400 depending on internship location. If you decide to do something more expensive during the internship period such as a guitar-building workshop, art classes or intensive language study, any cost beyond these budgeted amounts will be an additional out-of-pocket expense for you. Not included in the LEAPYEAR program fee are the following: Medical expenses: These include required immunizations, personal health insurance, optional travel insurance, and any medical or emergency expenses incurred during the program. Personal Spending Money: We recommend that participants budget a total of $1,300 of personal spending money during LEAPYEAR. $600 for spending money during the first Group Semester to cover the cost of using cybercafés, doing laundry, buying gifts, extra food/drinks, optional activities, etc. $600 for the Individual Internship Semester, and $100 for the retreat weeks. We recommend that you only bring $700 for the First Semester and retreat weeks, then another $600 for the Second Semester. Before traveling, we ask the students to set aside $200 of their personal spending money for emergencies. This rarely gets used, but we want to ensure they have access to it in case they need it. All airfares and Visas: Airfare to and from home and the LEAPYEAR campus if needed; and both international airfares. LEAPNOW arranges all international flights through one travel consultant so that our groups can travel together, and to take advantage of the lowest group airfares. First semester airfare typically runs between $1200 - $1800. Internship airfare varies with your choice of destination. Visa costs also vary depending on destination. Passport: Please scan the photo page of your passport and email it to email@example.com along with your registration paperwork. We will need a copy of your passport to register you for the program and as the first step in securing your international flight. A delay in this step may increase ticketing prices. Please do not delay! Academics: LEAPYEAR students are enrolled as full-time B.A. undergraduate students at Naropa University (www.naropa.edu/). Naropa University is accredited through the Higher Learning Commission (HLC) and the North Central Association of Schools and Colleges (NCA). Naropa University was founded in 1974 and emphasizes wholeness-based education, contemplative practice, environmental stewardship, and community—values that permeate the LEAPYEAR program. Naropa offers majors in: Contemplative Psychology, Education, Environmental Studies, Music & Art, Religious Studies, Interdisciplinary and Peace Studies. These majors complement the LEAPYEAR curriculum for students who choose to continue their education at Naropa. (Note: A small number of past students have used LEAPYEAR to complete high school. Please call and talk to our staff if this is your situation. LEAPYEAR can also be done on a not-for-credit basis.)
LEAPYEAR 2018: Packet I— Acceptance and Registration Packet Page 4 Financial Aid: As full-time college students enrolled at Naropa University, all LEAPYEAR participants are eligible for Federal Financial Aid. Financial aid is accessed through the normal FAFSA (Free Application for Federal Student Aid) process. If you are considering using financial aid for LEAPYEAR, start the process now by filling out the FAFSA online at www.fafsa.ed.gov. Contact information for Naropa University Office of Financial Services: Naropa University Office of Financial Services: 303-546-3509 or firstname.lastname@example.org Web page: http://www.naropa.edu/costs-aid/aid/index.php Naropa School Code = 014652 (Needed to route your FAFSA information to Naropa) IMPORTANT: All Federal Financial Aid forms should be sent directly to the Naropa University Financial Aid Office – NOT to LEAPNOW.
LEAPYEAR 2018: Packet I— Acceptance and Registration Packet Page 5 2018 LEAPYEAR Academic Coursework: LEAPYEAR is organized into two semesters. First semester courses relate to the group travel abroad, and the second semester is organized around the individual internship and the final two retreats. Each student can earn two semesters (30 credit hours) of academic credit. Naropa courses are graded. Detailed course descriptions are available at www.leapnow.org/leapyear/curriculum.php. First Semester - INDIA Group: 1. Cultural Immersion: India: 10 weeks of direct immersion in the culture of India through volunteer work, spiritual seminars, Hindi or Tibetan language study, home stays, environmental work, and individual internships. (6 Credits) 2. Wisdom Traditions of India: Study of the spiritual practices of Buddhism, Hinduism and Sikhism including intensive practice of Hatha Yoga, Meditation & Karma Yoga. (6 Credits) 3. Practice and Community: The study of the process of creating conscious community as well as the practices that support living in community with self and others. Students learn to define and live within clear agreements, learn clear communication and conflict resolution, and do daily contemplative practices while traveling together in unfamiliar countries through unfamiliar inner and outer territory. (3 Credits) First Semester – LATIN AMERICA Group: 1. Spanish Language Immersion: Four weeks of formal Spanish study and 9 weeks of practical Spanish immersion through homestays and volunteer work. (6 Credits) 2. Cultural Immersion: Latin America: Direct study of the people and cultures of indigenous and modern Latin American in Central & South America. (6 Credits) 3. Practice & Community: See description above. (3 Credits) Second Semester Courses (all students): 1. The Whole Human Being: An embodied exploration of the journey back to wholeness and into adulthood. Students study what it means to live a life of health and wholeness while directly exploring the body/mind continuum. This exploration integrates contemplative practices with study of the development and evolution of the human being and includes intensive workshops on integrity, conscious communication, health, nutrition, emotional literacy and the practice of creativity in an embodied life. (4 credits) 2. The World as Classroom: A 12-week internship focused on service work in a part of the world that is of particular significance to the student and their developing interests. This independent experience exposes the student to diverse cultures, broadens their horizons and deepens their understanding of their own worldview, opening them to myriad aspects of the world while exploring their own cultural assumptions. (6 credits) 3. Being the Change: Students learn skills needed to “be the change we wish to see in the world.” (Gandhi) Students take a vision and see it through to a practical outcome as well as study the power of reframing, setting intentions and life path visioning. (2 credits) 4. Diversity and Multiculturalism Seminar: This course emphasizes the development of knowledge, critical thinking, analytical skills, and interpersonal and intergroup interactions necessary for living and working in an international setting characterized by diversity. Students engage in inquiry and analysis of the complexities of multiple and competing theories of race, class, gender, ethnicity, disability, age, sexuality, nationality, and religion, and how they shape and are shaped by social and cultural life in the world around them. (3 credits)
LEAPYEAR 2018: Packet I— Acceptance and Registration Packet Page 6 PROGRAM OVERVIEW: During the Spring 2018 LEAPYEAR program the first semester is spent traveling as a group to India & Nepal or Central America. All retreats are held at our Northern California campus. India & Nepal Sample Itinerary: Land in New Delhi, the capital city of India, for 2-3 days of orientation. Learn about the languages, history and food of north India. Volunteer with bears and elephants at an animal rehabilitation center near Agra. Study Hindi language while taking classes and exploring traditional arts on the Ganges in Varanasi, one of the world’s oldest cities. Buddhist meditation retreat in Bodh Gaya where the Budhha himself attained enlightenment and offered his first teachings. Orientation in Kathmandu, with a focus on local religion, art and culture. Serve earthquake-affected communities and support relief and re-construction projects. Learn and practice yoga and meditation while working with children in the Kathmandu Valley. Trek in the awe-inspiring Himalayas. Central America Sample Itinerary: Land in Guatemala and do orientation in Comalapa. Build a school from tires & reclaimed materials. Two weeks of Spanish language immersion and homestays in the town of Quetzaltenango, a Mayan cultural center. Afternoons are spent volunteering with local non-profits. 3-4 day overland trek to Lake Atitlan through volcanic terrain & indigenous villages. 8-9 days of spiritual study and contemplation on Lake Atitlan at the foot of a volcano Fly to the Bay Islands of Honduras for 4-5 day SCUBA training and diving on the island of Roatan. Travel to Matagalpa, Nicaragua for another two weeks of Spanish language training and volunteer work. Two weeks of permaculture and sustainable community on the island of Ometepe, in Lake Managua. Second Semester Individual Internship: For ~10+ weeks in the summer semester, each participant travels on their own to do an internship of their choice, chosen from thousands available in 126 countries. The internship follows naturally after the first group semester, and the Rite of Passage – allowing the participant to deeply explore a region or type of work that engages them fully, while relating to the world as an individual and an adult. Students choose the internship during the first half of the program, and make the placement with the assistance of LEAPYEAR staff. The internship is intended to be a chance to explore an interest, career or region in depth and in a structured way. It’s a chance to serve others while deepening one’s engagement in the world. It is NOT intended for wandering, pursuit of distraction, or simply traveling around. It is a chance to give to learn, rather than “consuming” experiences. Past LEAPYEAR students have: worked at orphanages & spiritual centers in India, studied Chinese and kung fu, apprenticed with blacksmiths, studied art in Indonesia and central Mexico, taught school in Patagonia, worked with baboons in South Africa, taught autistic children in Vietnam, worked with a midwife in Bali or street children in Guatemala & worked on farms in New Zealand. Internship Preparation: Once you have confirmed your LEAPYEAR enrollment you will receive specific instructions and sample programs in Packet III to begin the process of choosing your internship. During the first retreat, students meet as a group, then individually with internship staff to learn about the many options available. During the first semester group travel, students dialogue on-line with our internship placement specialist, then settle on a specific internship during the second retreat. To support the internship placement, each student prepares a resume and cover letter – to practice presenting themselves to the world in a professional way.
LEAPYEAR 2018: Packet I— Acceptance and Registration Packet Page 7 ON CAMPUS RETREATS Schedule: Four intensive LEAPYEAR retreats totaling ~7 weeks form the backbone of the LEAPYEAR program and distinguish LEAPYEAR from all other gap year and college programs. Each retreat is held at the LEAPNOW campus in Sonoma County, just north of San Francisco. Retreats are inner-directed intensives that are focused on setting the context of the program, and exploring the context of your life. Each day begins with an hour of physical movement and contemplative practice such as meditation or yoga. After breakfast, we spend 2 & 1/2 hours in the morning and occasionally 2 hours in the evenings on the LEAPYEAR Living Skills Curriculum (detailed at www.leapnow.org/leapyear/curriculum.php). After lunch we do three hours of physical work (construction, landscaping, and gardening). Participants take turns doing all the cooking and baking for the group with local organic foods, and also do most cleaning and maintenance. Together we create a high level of conscious community, and a rigorous daily rhythm of practice, work, learning, free time and play. We put aside cell phones, texting, the Internet and other media during retreats. Rite of Passage: Third Retreat culminates in a three-day formal rite of passage. Parents come to our campus for two days in May to witness their son or daughter’s passage into adulthood while consciously letting them go & giving them their blessing. This weekend is the fruit of a lot of work on the part of the students and marks a major transition for both students & parents. The Parent Packet will give you specific information about preparation and logistics for this weekend. This weekend is set for May 26-67, 2018. Please block out time for this important event now to avoid schedule conflicts. Expectations During Retreats: We expect all group members to treat one another with basic respect and consideration, and participate fully in all activities and in the life of the community. In general, the following behaviors are out-of-bounds on retreat as well as while studying abroad, and if a student engages in these behaviors and is unable to make positive changes after receiving feedback, they will be sent home: If the student engages in behavior that puts the program at risk; If the student engages in behavior that puts group or staff members’ health, safety, or well- being at risk; If the student puts their own health, safety or well-being at risk. Retreat weeks are designed to give students a chance to enhance their relationship to health and well-being, and break the grip of habitual ways of tuning out. To these ends, we run a smoke, alcohol and drug-free campus, and retreat weeks are media-free. This means that you should not expect to surf the Internet, use a cell phone, play video games, use your iPod or laptop, or watch DVDs during retreats. General Disclaimer: LEAPNOW reserves the right to make changes to our programs at any time. Changes may be required to provide the best possible experience, safeguard participants or respond to changing political conditions, dramatic weather events, or other unforeseen circumstances.
LEAPYEAR 2018: Packet I— Acceptance and Registration Packet Page 8 Student Registration and Tuition Agreement, Consent & Waiver (page 1 of 6) This agreement is made by and between _______________________________________________________ “Student” residing at: ______________________________________________________________________________ Full Home Address and LEAPNOW, Inc., a California corporation. This agreement and all required registration forms must be completed and received before the Student may begin the 2018 LEAPYEAR program. I/We hereby enroll the above Student in the LEAPYEAR program for the academic year starting in 2018 under the following terms and conditions: 1. I, __________________________choose to participate as a student and volunteer worker in the LEAPYEAR 2017-18 program. I further understand that I will choose a country and region of the world for my second semester solo internship. The choice of country and region will be subject to my [and my parent(s)] approval, and I will be traveling in said country and region on my own. I have read and understood the information set forth in the LEAPYEAR 2018: Acceptance & Registration Packet. 2. In consideration of LEAPNOW holding a place for the Student in the LEAPYEAR program, Parent(s) and Student jointly and separately agree to pay the program fee of $34,900 in full to Naropa University. LEAPNOW agrees to provide educational services in the form of the LEAPYEAR Program. I understand that this program fee must either be paid in full at the time of enrollment, or according to the following payment schedule. Fee Schedule for LEAPYEAR 2018: Confirmation Fee $7,900 Payment 2: January 5, 2018 $6,750 Payment 3: February 2, 2018 $6,750 Payment 4: March 23, 2018 $6,750 Final Payment: May 4, 2018 $6,750 Total of all Installments $34,900 Student and Parent(s) understand that the Program’s operating budget is based upon specific enrollment factors and, accordingly, agree to be responsible for paying tuition in full at the time of enrollment or in the installments detailed above. The Student will not be allowed to continue the program if payment falls behind by 15 days or more. If responsibility for a Student’s tuition is shared, default or delinquency of prompt payment by either party will jeopardize the Student’s attendance. Student and Parent(s) understand that the confirmation fee and the entire program fee is non-refundable. 3. Student and Parent(s) understand that the budget for the Individual Internship in the Second Semester is capped at $2,500. Additional costs are the responsibility of the Student and Parents, as are any medical expenses accrued during and after the program, and all personal spending money during the LEAPYEAR program. Parent’s Initials: _____ _____ Student Initials: _____
LEAPYEAR 2018: Packet I— Acceptance and Registration Packet Page 9 LEAPYEAR 2018: Student Registration and Tuition Agreement, Consent & Waiver (page 2 of 6) 4. Student and Parent(s) agree to withdraw the Student upon request if tuition payments are not made when due or if LEAPNOW, in sole discretion, determines that the welfare of the Student or the program requires such withdrawal. LEAPNOW retains the right to determine whether or not the Student’s continued enrollment is in the best interest of the Student or the LEAPYEAR Program. LEAPNOW cannot anticipate or list all the possible reasons why it may be necessary to terminate enrollment, but these include violation of LEAPYEAR policies or any behaviors that jeopardize the health or well-being of the Student, the LEAPYEAR program, other students, placement sponsors, or LEAPYEAR staff. LEAPNOW retains the exclusive right and has discretion to determine what procedures to follow and to decide what reasons justify termination of enrollment or any other discipline. Upon withdrawal, dismissal, or the end of the program year, all books, program materials, and LEAPNOW property must be returned to LEAPNOW or the Student and Parent(s) will be billed for replacement costs. 5. I understand that LEAPYEAR is an educational program. It is not therapeutic in design, intent or methodology and is not a substitute for medical treatment, psychotherapy, or any health program, regardless of what you might have heard from anyone. We specifically advise you that LEAPNOW, Inc. does not supply healthcare professionals on the staff. 6. Student and Parent(s) agree to provide LEAPNOW with completed and candid health forms and all necessary student record forms. Non-disclosure of vital physical or emotional health information, or providing false information on our disclosure forms may be cause for termination from the program. 7. Health and Liability Insurance. I affirm that I have adequate health and/or other insurance to cover any injury or damage I may cause or suffer while participating in the Activities, or that I am financially able and agree to bear the costs of such injury or damage to myself, property, or others. 8. Medical Authorization. I hereby authorize LEAPNOW, Inc. or any of its representatives to obtain any reasonably necessary emergency, surgical, or other medical care for me, including hospitalization. I understand that LEAPNOW, Inc. does not provide medical services and is not responsible for ensuring the presence of any medical professionals at its locations. In the event that any representative, volunteer, affiliate or agent of LEAPNOW, Inc. voluntarily administers emergency medical care to me, I hereby release such individual(s) from any and all liability with respect to such emergency medical care. 9. Student and Parent(s) hereby authorize and give full consent to LEAPNOW to publish and copyright all photos in which the Student appears and were taken while enrolled as a Student in the LEAPYEAR program; this may include newspaper or magazine ads, internet web pages, etc. 10. I understand that LEAPNOW, Inc. does not want to reduce my enthusiasm for participating in its programs and that LEAPNOW, Inc. as a matter of integrity and accountability wants me to know in advance of the inherent or potential risks of the LEAPYEAR Program and the associated activities. I understand that LEAPNOW, Inc. takes reasonable steps to provide a safe environment. However, I also understand that certain risks are inherent in the program and cannot be eliminated without destroying the unique character of the program. 11. I understand that the LEAPNOW program in said countries exposes me to a series of risks, of which some are listed below and in other information provided to me by LEAPNOW, many of which could result in my death. I have read the detailed descriptions of warnings and hazards associated with such countries, found online at the U.S. State Department website: https://travel.state.gov/content/passports/en/alertswarnings.html . I understand and accept those risks listed, and any other risks associated with the LEAPNOW program in said countries and the U.S. The risks discussed above include, but are not limited to: Travel by air, bus, van, train, boat and on foot. Travel to and from our U.S. and international program sites, and to and from a site of emergency medical care; Parent’s Initials: _____ _____ Student Initials: _____
LEAPYEAR 2018: Packet I— Acceptance and Registration Packet Page 10 LEAPYEAR 2018: Student Registration and Tuition Agreement, Consent & Waiver (page 3 of 6) Acts injurious to your person or property due to contact with natives of each country and the U.S.; Sickness and disease; SCUBA diving, horseback riding, hiking, trekking and other physical activity; Culture shock and homesickness; Use of power & hand tools & other risks associated with construction, landscaping & kitchen work; Political and/or social unrest; Risks associated with outdoor physical activities (such as walking or running on uneven ground) including slips and falls, bruises, sprains, lacerations, fractures, and concussions; Contact with plants, animals, snakes or insects that could cause stings, bites, allergies, or disease ; Exposure to fire or heat from natural or manmade causes that could cause burns, dehydration, and fainting; Exposure to cold, wet weather, to other unpredictable forces of nature, and acts of God; Exposure to the conduct of other LEAPYEAR participants; Damage to property owned by me or by others; The failure or malfunction of equipment; Inherent risks associated with being in a remote location, distant from medical facilities, where evacuation and medical care could be delayed; Risks associated with swimming in pools and bodies of waters found at LEAPYEAR locations; I understand that this list is not complete and that other unknown or unanticipated risks may result in property loss, serious injury, illness, or death. 12. I affirm that I am physically and mentally able to do such activities as may be required of me by the LEAPYEAR program, as well as those that are unexpected in relation to the risks I face by living and working in said countries. I have no medical or psychological problems which may be affected by my activities in the LEAPYEAR program and by my other activity in said countries, including travel to, from, and within said countries. I understand that LEAPNOW staff do not diagnose, prescribe, or treat for physical or mental illness. 13. Assumption of risk. I understand and agree that LEAPNOW, Inc. is not and cannot be a guarantor or insurer of my safety or well-being. I agree to act with reasonable care for my well-being and the well-being of all other people and property around me during the Program. I accept and assume full responsibility for all of the risks and hazards associated with participation in LEAPYEAR, whether known or unknown. I elect to participate in the LEAPYEAR with full knowledge of all known or unknown risks. 14. LEAPNOW Program Expectations and Rules. I understand that for any group of human beings to thrive while living together, there have to be basic guidelines of behavior and expectations that all group members agree to abide by. I further understand that the following are basic non-negotiable rules that govern LEAPYEAR groups, and that I will have to abide by them if I choose to take part. I, as a student in this program, agree to each of these rules and expectations and signify this agreement by initialing each point: I understand this program is for those who are willing to challenge themselves physically, culturally and socially. I am willing to work hard, take on challenges, participate fully and make a difference. I am not doing this program as a vacation or party, therapy or escape. ______ I agree to treat all group members and the leaders with basic respect and consideration. ______ I understand that if I engage in behaviors that put the program, another group member, a trip leader or my own health, safety or well-being at risk, that I may be asked to leave the program. I understand that risky activities include but are not limited to, bungee jumping, canyon swing, sky diving, hang gliding, paragliding/sailing, white-water rafting, as well as driving or riding motorcycles, all terrain vehicles or mopeds. ______ I agree to make positive changes in my behavior after receiving feedback about negative behaviors or I may be asked to leave the program. ______ Parent’s Initials: _____ _____ Student Initials: _____
LEAPYEAR 2018: Packet I— Acceptance and Registration Packet Page 11 LEAPYEAR 2018: Student Registration and Tuition Agreement, Consent & Waiver (page 4 of 6) I understand that because of the risk of HIV, staph infection, syphilis, tuberculosis, and hepatitis from poorly sterilized equipment at unregulated tattoo parlors outside the U.S, LEAPNOW has a no- tattoo and no-piercing policy during the LEAPYEAR program. ______ I understand that the program is DRUG AND ALCOHOL FREE. Any drug or alcohol use, purchase or possession during the program results in immediate termination, and subjects the violator to the Second-Chance Policy (see below). I understand that drug and alcohol use runs counter to the intention of LEAPYEAR, which is to build a high level awareness of self and others. This includes abuse of prescription medication, purchase or possession of drug paraphernalia, and the use of tobacco or e-cigarettes/vaporizers. I understand that past participants have been asked to leave the program for the above reasons, and that I may be subject to a drug test if I am found behind closed doors if drugs are present. I also understand that if I bring drugs or alcohol at the start of the program I will forfeit any monies paid to the date I am asked to leave and that the Second-Chance Policy will not be available to me. ______ In LEAPNOW’s efforts to ensure my safety I am required to stay the night at LEAPNOW sponsored residences and I may be asked to adhere to a curfew by my leaders or local hosts. ______ If I create a “mess” during the program, it will be my responsibility to make amends within 48 hours. A “mess” can be a physical mess, a problem for another group member, host family, leader or program sponsor, or other problem that an adult would clear and clean up – to restore harmony and make amends. ______ I understand there are times during the program I will be asked to set aside my cell phone, laptop, iPod and other media devices. I agree to abide by the media policy as laid out by LEAPNOW staff and leaders. I understand that I will not travel with a cell phone during the first semester group travel. For emergency contact, my trip leaders will carry cell phones. ______ The following may be grounds for dismissal: Unwanted sexual advances, verbal abuse, physical violence, property damage, theft, visits to strip clubs/prostitutes and/or the breaking of local laws. ______ I agree to take responsibility for my health and well-being. I will follow health and safety guidelines laid forth by LEAPNOW. If I am prescribed medication before or during the program, I agree to follow my physician’s instructions and regulate any changes in my medication in consultation with my prescribing physician. ______ I understand that cultural norms about behavior and dress are more conservative than they are in the United States, especially for women. For my safety and well-being, I agree to stay within the guidelines given to me by the program trip leaders and sponsors. ______ Second Chance Policy. I understand that since LEAPYEAR is an 8-month program, and people make mistakes, there is a way to re-enter the program if I have stepped out-of-bounds and have been asked to leave. I further understand that if I am asked to leave during the First Semester group travel I will forfeit the rest of the abroad portion of the First Semester, and must complete the re-entry process outlined in the following paragraph. I understand that after completing the re-entry process I will be able to re-join the program after the abroad portion of the semester is done. I also understand that if I am asked to leave during a retreat portion of the program, I must depart and begin the re-entry process, rejoining after completing the process. The Re-entry Process: To be considered for re-entry to the program, a student must leave and complete 120 hours of volunteer service work with an organization that the student and the LEAPYEAR staff agree upon together. During this time, the student will check in with a LEAPYEAR staff member each week, and must receive a satisfactory report from the volunteer agency about his/her attendance, attitude, and hours worked. The student will also have to do a re-entry interview with a LEAPYEAR staff member, create a strategy and support system for not making the same mistake(s) again, and make up any work that the rest of the group has done (journaling, reading, presentations, etc.). I understand that re-entry is at the discretion of LEAPYEAR staff. ______ Parent’s Initials: _____ _____ Student Initials: _____
LEAPYEAR 2018: Packet I— Acceptance and Registration Packet Page 12 LEAPYEAR 2018: Student Registration and Tuition Agreement, Consent & Waiver (page 5 of 6) 15. In lawful consideration for being permitted by LEAPNOW, Inc., a California corporation (also referred to herein as "LEAPNOW") to participate in the LEAPYEAR program, I hereby agree that I, my heirs, assigns, guardians, distributees, personal representatives, executors, and relatives will not make a claim or file a lawsuit against, attach the property of, or prosecute LEAPNOW, and their agents, employees, contractors, joint venturers, partners, assigns, directors, officers, shareholders, and successors-in-interest for injury or damage resulting from the negligence or other acts, however caused, by any employee, agent, volunteer, or contractor of LEAPNOW, or as a result of my participation in any and all LEAPNOW activities. I further agree to indemnify LEAPNOW, their agents, employees, owners, directors, officers, shareholders, successors, and assigns and to hold them harmless from any and all liability, responsibility, and obligation to me, including but not limited to liability for all acts of negligence which may be committed in the LEAPYEAR program and by its agents, contractors, and employees, which acts may result in injuries to me. This agreement to indemnify and hold harmless extends to my heirs, assigns, guardians, personal representatives, executors, and relatives. This indemnity agreement extends to all costs of litigation, including attorney's fees. 16. Further, in consideration for the presentation of the LEAPNOW program to me, I agree to release and forever discharge LEAPNOW from any and all such liability, responsibility, and obligation to me arising out of the LEAPNOW program, and I voluntarily and completely waive all of my rights, whether they are known to me or unknown to me, pursuant to California Civil Code Section 1542, which reads as follows: A general release does not extend to claims which the creditor does not know or suspect to exist in his favor at the time of executing the release, which if known by him must have materially affected his settlement with the debtor. 17. Mediation, Arbitration, Waiver of Right to Sue. I expressly agree that any claim or cause of action of any kind against LEAPNOW, Inc. as a direct or indirect result of my participation in its programs, must first be submitted to mediation by a neutral third party, preferably a mediator who practices regularly under the auspices of the courts of the state where LEAPNOW, Inc. is located. If after four (4) sessions, mediation is unsuccessful, the matter must then be submitted for a final and binding arbitration of my claims. Any such arbitration will be held in the state where LEAPNOW, Inc. is located, and California substantive law will apply in all such proceedings without regard to choice of law principles. I agree that any resulting arbitration award is final and binding upon both LEAPNOW, Inc. and upon me and my Heirs, and by executing this Agreement I am expressly waiving any and all rights to litigate any such claim in any state or federal court. Any cause of action to enforce any arbitration award or any cause of action brought against LEAPNOW, Inc. notwithstanding the waivers contained in this Agreement, must be brought in a court of competent jurisdiction in the state where LEAPNOW, Inc. is located, and California substantive law will apply. Any arbitrator chosen pursuant to this paragraph will be chosen from a list or lists supplied by the American Arbitration Association (“AAA”), with AAA rules to apply, and/or the Federal Mediation and Conciliation Service, or from any other mutually agreeable source. 18. If it is necessary for LEAPNOW to take legal action to collect any amounts payable hereunder, Student and Parent(s) agree to pay reasonable attorney’s fees and costs. Student and Parent(s) also agree to pay LEAPNOW for any damages caused by their child to the Program or its property. Student and Parent(s) understand that LEAPNOW’s financial liability for the LEAPYEAR Program cannot exceed the unused prorated portion of the LEAPYEAR program fee 19. I understand that execution and timely delivery of this Consent and Waiver are preconditions for my being permitted to participate in the LEAPNOW program. 20. The invalidity of any provision herein does not affect the validity of any other provision. 21. The parties agree that the venue for resolution of any disputes arising out of this contract shall be in the Sonoma County Superior Court, or for arbitration or mediation in Sonoma County, California. Parent’s Initials: _____ _____ Student Initials: _____
LEAPYEAR 2018: Packet I— Acceptance and Registration Packet Page 13 LEAPYEAR 2018: Student Registration and Tuition Agreement, Consent & Waiver (page 6 of 6) I, the Student, and we, the parent(s)/guardian(s) financially responsible for the student(s), have read and understood this Student Registration and Tuition Agreement, Consent & Waiver, as well as the rules concerning payment of the LEAPYEAR Program Fee. As parents/guardians, we understand that in signing this agreement, we are agreeing to have at least one parent attending the LEAPYEAR Rite of Passage weekend in May 2018. ____________________________ ___________________________ ________________________ Student Signature Printed Name Date ____________________________ ___________________________ ________________________ Parent/Guardian Signature Printed Name Date ____________________________ ___________________________ ________________________ Parent/Guardian Signature Printed Name Date REGISTRATION PACKET: Please SIGN and initial this six-page Registration Agreement. Students are required to initial each program expectation and rule on pages three & four of this agreement. Then SEND (via email, fax or mail) one copy of the signed six-page document to LEAPNOW. Please keep a second copy of the signed forms for your records. LEAPNOW office address: 11640 Highway 128 Calistoga, CA 94515 Email: email@example.com Fax: 707.431.8479 Phone: 707.431.7265 PASSPORT: Scan and email a copy of the picture page in your passport to LEAPNOW. CONFIRMATION FEE: Please follow the directions on the attached form to pay your confirmation fee directly to Naropa University. HEALTH AND WELLNESS DISCLOSURE FORM: Please complete and return this attached form to firstname.lastname@example.org.
LEAPYEAR 2018: Packet I— Acceptance and Registration Packet Page 14 Confirmation Fee Payment Instructions The confirmation fee for the program is $7,900. Please submit this payment directly to Naropa University via the following methods: Credit Card: Naropa accepts Visa, MasterCard, American Express and Discover. You can pay online through your MyNaropa account. Log in and navigate to Admissions > Future Students and then choose the LEAPYEAR Confirmation Fee option. Naropa can also take your payment over the phone. Please be prepared to provide your credit card number, CVV code, and expiration date. Check: Include student name and ID number in the memo field of the check Make checks payable to Naropa University and address to: ATTN: Coordinator of Student Accounts 2130 Arapahoe Ave Boulder, CO 80302 Naropa University Contact Information For any payment related questions, contact Diana Conley, Director of Students Accounts via phone at 303-546-3554 or email at email@example.com. For help accessing your myNaropa account, contact the Naropa IT Help Desk at (303) 245-4609.
LEAPYEAR 2018: Packet I— Acceptance and Registration Packet Page 15 LEAPYEAR Health and Wellness Disclosure Form (page 1 of 2) Dear Students and Parents, LEAPYEAR is designed to be an enriching and challenging experience. If you attend a US college, new challenges can include meeting new people, more academics with less structure, and greater access to substances and alcohol. Participating in LEAPYEAR adds culture shock, new situations every 10-14 days, a different language, new food, water and intestinal upsets, living from a backpack, reduced access to known social support structures and many other stresses. LEAPYEAR can be much more emotionally, socially, physically and mentally challenging than college in the U.S. Under these stresses, even mild physical or mental health conditions can be exacerbated when you are far from home and in countries that provide less than adequate mental health support. It is vitally important to disclose all health issues to LEAPYEAR staff, physical and mental, so that we can know of any conditions, past or present, which may affect your safety and well- being during the program. This allows us to design a wellness plan for your time in LEAPYEAR. It is not in service to the student to withhold relevant health information and hope for the best, or to think that a change of scene will cause a transformation, or to underestimate the challenges inherent in the design of LEAPYEAR. LEAPYEAR doesn't work well if any of the following are true: Your ego strength, confidence or resilience has been significantly compromised by trauma, chronic depression or anxiety, or other recent or chronic life challenges. You are doing the program because your parent(s) think it is a good idea, but you aren't convinced. Your parent's motivation won't help you when you are in another country. You actively think about suicide or self-harm and/or you haven't received counseling or treatment. You have an undiagnosed or untreated eating disorder. You use the program to detox from substances, alcohol or tobacco. Detox takes time and makes everything more difficult as you travel. It doesn't work to stop using right before LEAPYEAR. So students and parents, please don't withhold issues (diagnosed or undiagnosed) from us and then expect us to be able to deal with them effectively while traveling when they come up. We want all students who enroll to be successful, so we need to accurately know your past challenges. If we know them, we can work with them. If we don't, you may be putting your well-being, health and money at risk. Warmly yours, Cassie, Rebecca and the LEAPYEAR Staff
LEAPYEAR 2018: Packet I— Acceptance and Registration Packet Page 16 LEAPYEAR Health and Wellness Disclosure Form (page 2 of 2) Please answer the following questions candidly. For any YES answers, please add another page to describe the situation or condition in detail. We reserve the right to request further information and to speak with doctors, counselors, etc. The information provided on this form will be handled confidentially and will be shared with program staff or appropriate professionals only when pertinent to your safety and well-being. 1. Have you ever been asked to leave school or a previous program? YES NO 2. Do you have any physical, psychological or chronic condition that limits your participation in any physical activities? YES NO 3. Have you been treated for a psychological condition in the past 3 years? YES NO 4. Do you take prescription medications for any health or psychological conditions? YES NO 5. Have you been or are you currently being treated for substance abuse? YES NO 6. Have you used alcohol during the past 12 months? YES NO 7. Have you used drugs during the past 12 months? YES NO 8. Do you now or have you ever smoked or used nicotine in any form? YES NO 9. Have you committed a crime within the past 3 years? YES NO 10. Have you been hospitalized in the past 5 years? YES NO 11. Are you UNable to swim? YES NO Do you have or have you ever had any of the following? 12. Dietary restrictions or special needs? YES NO 13. Allergies or Asthma? YES NO 14. Learning Difference? YES NO 15. ADHD or ADD? YES NO 16. Seizures or Epilepsy? YES NO 17. Diabetes, Heart or Lung Disease, Hepatitis or Jaundice? YES NO 18. Intestinal Problems? YES NO 19. Eating Disorder? YES NO 20. Depression or Anxiety? YES NO 21. Suicide Ideation or Attempt? YES NO 22. Motion Sickness? YES NO How many non-work hours do you spend per week on a computer or gaming (includes video games, social media, web-surfing, etc…) I have included an additional page elaborating on any ‘YES’ answers. YES NO I take full responsibility for my medical, psychological and physical condition for the duration of my LEAPYEAR program. I am unaware of any further medical, psychological and physical problems that might inhibit my ability to successfully complete the program. Should any problems arise during the course of the program, I will promptly notify a LEAPYEAR staff member. I understand that if I withhold or misrepresent vital information from my past, I may be asked to leave the program. Student Name: Signature: Date: I have read and reviewed the two-page Health and Wellness Disclosure above, and, to the best of my knowledge, it is accurate and complete. Parent Signature: Date:
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