Fill - Free fillable Friday September 17 to Sunday September 19, 2021 PDF form

Honoured seeker,

We are pleased to include you in this New Warrior Training Adventure (NWTA). This is a very

powerful and personal experience, in the company of a diverse group of men.

In order for you to get the most out of the upcoming training, consider these pages carefully and

prepare a breathing space for the weekend adventure (and some for afterwards, if possible), so

that you can give the training your entire focus.

Paperwork:

The following accompanying forms must be completed, signed, and returned by email as a PDF

file within 10 days of receiving this package:

• Application Registration and Consent

• Confidentiality Agreement

• Participant Assumption of Risk and Personal Responsibility

• Chilliwack Lake Camp Agreement and Acknowledgement of Risks

• MKP COVID Waiver

These completed forms must be emailed as a PDF file to mkpbcregistrar@gmailcom .

If you are technologically savvy, they can be filled out and signed electronically with a digital ID.

Click here for instructions on using digital IDs. If you cannot get the digital ID to work, start by

updating to the latest Adobe Acrobat Reader.

Alternatively you can print them, fill them out, scan them to a PDF, and then email them. There

are many smartphone apps now, such as CamScanner, that can scan files to your phone.

All forms must be signed with a digital ID or an actual signature.

If all of the above is technologically beyond your grasp, fret not, I assure you that there is

someone among your family, friends, or community who can help you with this. Public libraries,

for instance, are a great place to print, scan, and get technological assistance.

The New Warrior knowing his purpose as a man, draws upon his powers of creation

accordingly, to derive significance from his life.

Friday September 17 to Sunday September 19, 2021

Chilliwack Lake Camp, Chilliwack Lake, BC

On Highway 1 going through Chilliwack, take exit 119 (Vedder Rd) south (towards

Sardis)

Travel 5 km on Vedder Rd to Vedder River crossing - do not cross the bridge!

Before the bridge turn left (east) on Chilliwack Lake Rd

Travel 40.6 km to Chilliwack Lake Provincial Park campground

Go straight past the campground onto a very bad unpaved service road

Travel 8 km southeast and then south

At about the 7 km mark, turn right over Paleface Creek - do not go up the hill

Take the first right soon after that through a yellow gate into the camp



More detailed directions:

A map of the journey is on the following page.



Google directions from Highway 1 exit 119 (Vedder Rd) in Chilliwack to

Chilliwack Lake Camp (Note that you will not have cellular service for the

whole journey): https://tinyurl.com/MKPChilliwackLake

Tuition:

The total tuition is $850 ($800 if paid in full and received by August 31, 2021) less your $200

deposit. This amount is due by September 3, unless other arrangements are made.

Tuition can be paid online with a credit card or by PayPal at:

http://mkpcommunity.ca/page/bc-paypal

When a payment is made online, forward your e-receipt to mkpbcregistrar@gmail.com so

that it

can be verified.

Should it become necessary to make other arrangements, or to arrange a payment plan,

contact Mark Dziatko at (250) 884-2842 or kapoho@hotmail.com.

Directions to NWTA at Chilliwack Lake Camp:

The travel time from Chilliwack (Highway 1 exit 119) to Chilliwack Lake Camp is 1 to 2 hours

depending on the vehicle you are driving and how you drive on rough roads. The last 8km of the

journey is very rough and could take 45 min itself if in a small car like a Honda Civic. A truck or

4x4 is a preferable vehicle.

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Turn east at Vedder Crossing

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Emergency Phone Number:

There is no telephone or cellular service at the camp. There is a satellite phone we can

use for emergencies (this number will be supplied to you the week of the training) and

the regional helicopter medical evacuation service has our camp coordinates. Medics will

be on-site for the duration of the training.

Alcohol and Drugs:

In order to get full value from the training, do not drink alcoholic beverages, take drugs, or any

other consciousness altering substance at least 24 hours prior to the training, unless prescribed

by your doctor. Check with the staff about any prescribed medication needed during the NWTA.

Take responsibility for yourself regarding all health and medical needs.

Lodging:

Indoor sleeping space will be provided for each participant. Bring a sleeping bag, sleeping

pad, pillow, towel, flashlight, and a pair of shorts. Also bring appropriate clothing for the time

of year – jeans, long sleeve shirt, fleece, comfortable outdoor shoes, and rain gear.

Dress:

We suggest wearing comfortable loose fitting clothes – for indoors and outdoors – appropriate

for fall weather. Bring a couple of pairs of shoes including something appropriate for the

outdoors on Friday night.

Graduation Ceremony:

A graduation ceremony will usually be held at a location in your community within a couple of

weeks of completing the NWTA. Details will be announced at the NWTA. This is an opportunity

to share your new energy with New Warrior Brothers in the community and with those others

who are important people in your life. Plan on inviting your family and friends now. Dress is

casual.

Arrival and Completion Times:

You are to arrive between 5:30 and 6:00 pm on Friday, September 17. The training will

be completed by 5:00 pm on Sunday, September 19.

Carpooling:

In the interest of energy conservation, parking, and most of all, as an opportunity to connect

with

each other, we strongly encourage car pooling. You will be contacted by a staff member

prior to

the weekend to make arrangements.

Meals:

Meals will be provided except for Friday evening (arrive fed) and the following:

Prepare and bring with you a special dish to serve at least six men. Provide directions

including assembly, cooking and/or warming instructions. Indicate any common food allergens

that may be present in the dish you bring. (i.e. Wheat, Dairy, Soy) We ask that your dish,

whether an appetizer, salad, main course or dessert, be healthy. Heavy meals are

discouraged. Mark your containers so that they can be returned to you.

Integration Groups:

After a New Warrior Training Adventure weekend, each man has the opportunity to participate

in an initial Integration Group. This is a place where you can experience a continuation of what

you gained during his weekend training. These groups provide the opportunity to integrate into

your life the new insights and energies received on the New Warrior Training weekend and to

receive strong support and safety from other men.

Men say that these sessions add powerfully to their weekend experience, produce fabulous

individual growth, and provide them with an even stronger sense of support and community.

Many have said that they gained even more during the Integration Group sessions than on the

Weekend Training itself; even though, after the weekend, they didn’t think that was possible.

We will discuss Integration Group (I-Group) choices on Sunday morning and make plans for

each local community to involve the most men as possible.

We await your arrival at Chilliwack Lake Camp on

Friday September 17 between 5:30pm and 6:00 pm.

Registration/Consent Form

understand this training is educational. I understand this training is not psychotherapy or a substitute for psychotherapy.

2. I represent, covenant and promise that I am attending this training solely for my own benefit and not as an observer,

researcher, journalist, investigator or in any other capacity than as a participant. I am not attending this training with

any intention to report about or investigate the training or any of its processes or the other participants. Initial:_____

3. I understand that the New Warrior Training Adventure is the intellectual property of The ManKind Project and that The

ManKind Project owns the trademarks, trade names, service marks and copyrights related to the New Warrior Training

Adventure. Initial:_____

4. I covenant and promise that I will not write or speak about the training or reveal any of its processes, the names or

identities of other participants, or the experiences of other participants. The sole exception is that I may describe my

own experiences of the training, what happened for me, without specifically describing any process. Initial:_____

Date:______________________________

Name of Participant (PRINT):____________________________________

Signature of Participant:_______________________________________

1. I hereby covenant and promise to be at Chilliwack Lake Camp, BC between 5:30pm and 6:00pm on Friday, September

Name:__________________________________ Age:______

Address:__________________________________________________________

Telephone Numbers: Primary:_______________ Secondary:_______________

Registration Agreements:

2. I agree to not take any non-prescription drugs or alcohol within 24 hours prior to the training, and will advise the training

, 2021 and be in attendance until 5:00pm on Sunday, September 19

, 2021 or until the New Warrior

Training

Adventure (hereafter “training”) is over. I am aware that my failure to keep this agreement would greatly minimize the

value I would gain, both from the training and from the period before the training, and therefore will co-operate with the

staff in overcoming any circumstances that could prevent me from complying with this agreement.

staff of ALL drugs I have taken within 24 hours of the training.

Informed Consent Agreements:

1. I, ___________________________________ (PRINT), hereby voluntarily consent to participate in the training. I

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signature

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The ManKind Project

Participant Promise of Condentiality

While participating in the Program and the Activities, I will learn details of customs,

protocols, traditions, exercises, rituals, processes and other information, in both

oral and written form, which are proprietary and owned exclusively by MKP (the

“Proprietary Information”). In addition, I may learn during the course of the

Program information about other participants which is con

dential (the

“Con

dential Information”). As an express condition of my participation in the

Program, I agree that I will not reproduce, duplicate, copy, or otherwise disclose, in

any form or manner, written or oral, any Proprietary Information without the

express written permission of MKP. I further agree that I will not disclose in any

form or manner, written or oral, any Con

dential Information which I learn as a

result of my participation in the Program and Activities. I may, however, share my

personal experience of the Program and the Activities as long as the condentiality

of both the Proprietary Information and the Con

dential Information is

maintained.

MKP Promise of Condentiality

MKP agrees to maintain the condentiality of Con

dential Information as stated

above. However, if a participant in any MKP program reveals recent or continuing

acts that place himself or another person in danger of signi

cant physical,

emotional or psychological harm, or is considering engaging in such acts in the

foreseeable future, MKP may be mandated by law to report such information to an

appropriate agency or organization. Even in the absence of a state mandate, MKP

may act to protect the participant or any other person from foreseeable harm,

while providing the participant a path of healing and support.

NAME:

DATE:

SIGNATURE:

List every food and medicine you are allergic to, any other allergies, and any special dietary needs you have:

Describe any mental health issues you have that may create problems for you or others:

Participant Name:

Participant

Acknowledgement Regarding

Assumption of Risk and Taking Personal Responsibility

The ManKind Project o f Canada

Congratulations on your decision to participate in the Mankind Project New Warrior Training Adventure (the

“NWTA”)! The Purpose of this document is to let you know what you are getting yourself into and to ask you to

commit to taking personal responsibility for your own safety and wellbeing.

The NWTA generally takes place in a youth camp environment, with facilities that are often basic and in remote

settings. Some of the activities are very physical and may take place outside on difficult terrain where you will

be exposed to the elements. This is no spa weekend. You will have the opportunity to look deeply into your life

to see what’s working, what isn’t working and what is driving the unhealthy patterns of how you show up in

your relationships and in your life. The work you will do on the NWTA is physically, emotionally and

psychologically challenging. It isn’t for everyone. None of the activities or processes on the NWTA are

compulsory. Any man may choose to not participate in any process or activity. It is your responsibility to

determine for yourself whether you are ready for the NWTA. We do however, challenge you to move out of

your comfort zone and dare to discover your potential.

We are an all-inclusive, welcoming community. We have had men from many different walks of life and at very

different stages in their lives participate in the NWTA. Men on the NWTA range in age from young to well into

their elder years. Professional athletes and men who have quadriplegia can be found on these weekends.

We insist that you be willing to look after yourself, know your limitations and have the courage to decline from

participating in any activity or process which exposes you to risk beyond what you are willing to accept.

Describe any physical issues you have that could create problems for you or others:

Last edited: January 28, 2020ManKind Project of Canada

pg. 1 o f 2

RESET

No alcohol or illegal drugs are allowed. Describe any addictions you have that could create problems for you

or others:

Have you attempted suicide in the past 2 years?

☐

Yes

☐No

Have you been hospitalized for a psychiatric illness in the past 2 years?

☐

Yes

☐No

List the names of all the medications/drugs you take:

If you have any concern about your ability to participate in the weekend, we recommend that you obtain the

opinion of one or more of any health care professionals involved in your care. We also ask that you describe your

concerns in one of the spaces above, so we can be aware of your situation.

Are you presently, or have you ever been, on the Canadian National Sex Offender Registry or a similar Sex

Offender list in any other country? Yes No

Have you ever been convicted of sexual abuse or related offence, in Canada or any other country? Yes No

It's MKP Canada’s intent to create safety on this training. If you answered yes to either of the above questions

your application will be on hold and you will be contacted for clarification.

By signing this document you are acknowledging that there are risks associated with attending an NWTA, that

you are voluntarily assuming those risks, that you have sought the opinion of your health care professional (if that

is applicable), that you are committing to look after yourself on the NWTA weekend, and that you will take

personal responsibility for your own safety. You further certify that you have disclosed all physical,

psychological and psychiatric conditions that may impact your participation at the NWTA.

By affixing my signature on this document I acknowledge that I have read, understood and agreed to

abide by the attached ManKind Project International Ethics Policy.

PARTICIPANT

Print Name:

Signature:

Date:

Address:

Phone Number:

Email:

Last edited: January 28, 2020

EMERGENCY CONTACT

Print Name:

Address:

Phone N umber:

Email:

ManKind

Project of Canada

pg. 2 o f

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signature

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CHILLIWACK LAKE CAMP

6692 HERSHAM AVE.,

BURNABY, B.C. V5E-3K8

AGREEMENT AND ACKNOWLEDGEMENT OF RISKS

TO: ___ FOURSQUARE GOSPEL CHURCH OF CANADA _ (The “Church”)

AND: (the "Operator")

(INSERT NAME OF PERSON OR ORGANIZATION)

RE: Use of _ CHILLIWACK LAKE CAMP (the "Church Property")

In consideration of the Church permitting the Operator to make use of the Church Property and being

permitted by the Operator to participate in its activities on the Church Property:

I, ______________________ (participant’s name or name of the parent/guardian

of______________________) (together, the “Participant), recognize that I/my dependent will be involved

in indoor and outdoor activities at and near the Church Property. Activities involved in this trip may

include, but are not limited to camping, hiking, orienteering, swimming, rock or wall climbing, water

sports, games and sports, and team building initiatives.

I acknowledge, understand, warrants and represent that:

(a) outdoor activities present a wide variety of risks, hazards, and conditions (the “Risks”) to

the Participant with not all of them easily foreseeable, which could result in loss, damage,

expense, or injury, including death. These conditions may include, but are not limited to

variable weather conditions including heat, cold, and wetness, steep or uneven terrain,

evacuation difficulties, darkness, animal and plant life, rock or snow slides and use of

equipment, including various types of safety gear;

(b) The Risks simply cannot be eliminated without jeopardizing the essential qualities of the

activities that will be undertaken on the Church Property;

40 kilometres from the nearest pay phone or cell service and 57 kilometres from the

nearest hospital;

(d) There will be no representative of the Church on site during the Operator’s use of the

Church Property;

(e) All administration, improvements and Camp maintenance is done by volunteers as time

permits and the Church makes no warranty or representation as to the condition of the

Church Property, whatsoever, or that the Church Property is reasonably safe or that the

condition of the Church Property is such that the Risks can be mitigated or lessened or

eliminated;

(f) The Participant will uphold the standards of behaviour expected of them by the Church

and the Operator.

Mankind Project - BC

N/A

(g) The Participant waives any and all demands, claims, proceedings, causes of action,

judgments and expenses, and any other loss or damage against the Church or any of its

directors, officers, trustees, employees, members and volunteers, arising from or

connected with its use of the Church Property, howsoever caused;

(h) The Participant waives any and all demands, claims, proceedings, causes of action,

judgments and expenses, and any other loss or damage against the Church or any of its

directors, officers, trustees, employees, members and volunteers, arising from or

connected with any injury or damage to the person or property (including death)

occasioned in any way during the time that the Participant is on the Church Property,

including those resulting from the negligence or any other breach of duty owed by the

Church of its directors, officers, trustees, employees, members and volunteers;

(i) The Participant shall indemnify and hold harmless the Church and its directors, officers,

trustees, employees, members and volunteers from and against every demand, claim,

proceeding, cause of action, judgment and expense, and any other loss or damage, arising

from any injury or damage to his or her person or property of the Operator, including but

not limited to any bodily injury to the Participant (including death) occasioned in any

way during the time that the Participant is on the Church Property or otherwise;

The Participant acknowledges having read the foregoing and fully understands the same.

DATED this day of , 20 .

____________________________________ ______________________________

(Signature parent/guardian or participant 19 or over) (Printed name)

Assumption of the Risk and Waiver of Liability Relating

to Coronavirus /COVID-19

I am aware that this is a legal document which affects my rights. (initial)

The World Health Organization has declared the novel Coronavirus (COVID-19) a worldwide pandemic. COVID-19

is extremely contagious and is believed to spread mainly from person-to-person contact, including through

droplets and by touching surfaces. The Mankind Project of Canada (MKP-C) has put preventative measures in place

to reduce the risk of COVID-19 transmission but cannot guarantee that you will not be exposed to, or become

infected with, COVID-19. I acknowledge that attending MKP-C events like the New Warrior Training Adventure

or other MKP-C sanctioned in-person events could increase my risk of contracting COVID-19.

(initial)

By signing this agreement, I acknowledge that I am aware of the contagious nature of COVID-19 and voluntarily

assume the risk that I may be exposed to or infected by COVID-19 because of my attendance at and/or

participation in MKP-C sanctioned in-person events and that such exposure or infection may result in personal

injury, illness, permanent disability, and/or death. (Initial)

I voluntarily agree to assume all risks to me and accept sole responsibility for any personal injury, illness,

permanent disability and/or death suffered by me, including the risk that I may expose others to or infect others

with COVID-19 because of my/their attendance at and/or participation in MKP-C sanctioned in-person events.

______(Initial)

ON MY BEHALF, I HEREBY RELEASE, COVENANT NOT TO SUE, DISCHARGE, AND HOLD HARMLESS THE MANKIND

PROJECT OF CANADA (MKP-C), AND ITS BOARD OF DIRECTORS, EMPLOYEES, VOLUNTEERS, ARTISTS, INSURERS,

AGENTS, SPONSORS, VENUES, REPRESENTATIVES (“MKP-C Participants”) AND/OR ANYONE WHO MIGHT CLAIM

CONTRIBUTION OR INDEMNITY FROM ONE OR MORE OF THE MKP-C PARTICIPANTS OF AND FROM ANY CLAIMS,

INCLUDING ALL LIABILITIES, CLAIMS, ACTIONS, DAMAGES, COSTS OR EXPENSES OF ANY KIND WHICH ARISE OUT

OF, IN CONNECTION WITH OR RELATING TO MY ATTENDANCE AT AND/OR PARTICIPATION IN MKP-C SANCTIONED

IN-PERSON EVENTS (the “CLAIMS”). (Initial)

I specifically understand and agree that this release includes CLAIMS based on the actions, omissions, or negligence

of THE MANKIND PROJECT OF CANADA, AND ITS BOARD OF DIRECTORS, EMPLOYEES, VOLUNTEERS, INSURERS,

AGENTS, SPONSORS, VENUES, REPRESENTATIVES (“MKP-C Participants”) whether a COVID-19 exposure and/or

infection occurs before, during, or after my attendance at or participation in MKP-C sanctioned in-person events.

(Initial)

OVER

I am 18 years of age or older.

I understand that The Mankind Project of Canada or its agent and the venue owner/operator will retain my

contact information for 30 days in case there is a need for contact tracing on the part of the Provincial Health

Officer, in which case the information will be provided to the Provincial Health Officer.

SIGNATURE*: NAME (print):

*By using my electronic signature, I agree that my electronic signature has the same force and effect as my original handwritten signature would have

E-Mail and Telephone:

ATTENDANCE DATE:

LOCATION:

HEALTH SCREENING QUESTIONNAIRE

Do you have any of the following:

Fever

Chills

New or Worsening Cough

Shortness of breath

Sore throat

New muscle aches or headache

Have you travelled outside of Canada in the last 14 days? Yes No

Are you a close contact of a person who has tested positive for COVID-19? Yes No

SIGNATURE*:

*By using my electronic signature, I agree that my electronic signature has the same force and effect as my original handwritten signature would have

NAME (print):

E-mail and Telephone:

ATTENDANCE DATE:

LOCATION:

DATE SIGNED:

Chilliwack Lake

2021-09-17

Chilliwack Lake

2021-09-17

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