Counselor Application 2021

2021 Counselor Application

Please enter your information below.
General Information
Name *

First name Last name
Birth date *

Month Day Year
Current age *
Gender *

Male Female
Email *
example@example.com
Cell phone
Home phone
Mailing address *

Address line 1

Address line 2

City State / Province

Zip / Postal code Country
Current occupation/grade in school *
When were you baptized as an Seventh-day Adventist? *
Home church *
Marital status *

Single Married
Have you ever been arrested and/or convicted of a crime involving drugs, sex, or violence? *

Yes No
If yes, please explain:
Please attach a recent photograph of yourself if you have not been involved with YD Camp within the past two years.

Browse Files

Cancel of
Experience & Qualifications
List any past experience and qualifications for being a camp counselor (e.g. classes taken, leadership roles, etc.) *

Dates & Transportation
July 4–7: Camp Prep Workbee
July 7–11: Counselor Orientation
July 11–18: Camp Week 1
July 18–25: Camp Week 2
July 25–27: Counselor Retreat
July 27–Aug 1: Camp Cleanup Workbee
Please check all of the following travel options that apply to you *

I plan to be at Young Disciple Camp from July 7–25 (not staying for the counselor retreat). I plan to be at Young Disciple Camp from July 7–27 (staying for the counselor retreat). I plan to help with camp prep (give arrival date below). I plan to help with camp cleanup/tear down after counselor retreat (give departure date below). I will need to be picked up at the airport. I will provide the camp office with all flight details.* I will provide my own transportation to camp. I will bring a vehicle to camp that I can use for camp transportation and I can transport campers to nearby functions (give number below). I am willing to allow another licensed driver to use my vehicle for camp purposes. Other (specify below).
Arrival date for camp prep

Month Day Year
Departure date for camp cleanup

Month Day Year
Number of campers you can transport
Other travel arrangements
* Young Disciple provides airport pickup and drop-off service for those whose flights arrive at Spokane International Airport by 2:30 pm on July 7, and depart after 1:00 pm on July 25, or anytime within reason on July 27. Please send a copy of your flight itinerary to the YD office at least three weeks prior to camp.

Medical and Emergency Contact Information
Present health *

Excellent Good Fair Poor
Do you have asthma? *

Yes No
If yes, how is it controlled?
Previous bone or joint problems?
Please list any significant physical conditions or medical history (major surgery, seizures, mental/emotional illness, etc.)
Describe any significant allergies you have to foods, medications, and other substances you might encounter at camp. Please also list your reaction and preferred treatment.
Do you require gluten-free (GF) meals? *

Yes No
Medical Insurance carrier
Policy number
Emergency Contact
Emergency contact name *

First name Last name
Relationship *
Cell phone *

Camp Polo Shirt

Counselors will be provided with a staff polo shirt to wear during registration.
Please select your size: *

S M L XL XXL
References

Please list three references (not family members or Young Disciple employees) below. Please provide your references with a link to the online recommendation form found at youngdisciple.org/reference.
Reference 1: Teacher or employer *

First name Last name
Phone number *
Email *
example@example.com
Mailing address

Street address

Street address Line 2

City State / Province

Postal / Zip code Country
Reference 2: Pastor or church elder *

First name Last name
Phone number *
Email *
example@example.com
Mailing address

Street address

Street address line 2

City State / Province

Postal / Zip code Country
Reference 3: Other godly adult Christian *

First name Last name
Phone number *
Email *
example@example.com
Mailing address

Street address

Street address line 2

City State / Province

Postal / Zip code Country

Important Questions
Why are you applying to serve at Young Disciple Youth Bible Camp? *
Please read the summary of camp codes at youngdisciple.org/codes. Are you willing to pattern and support these codes? Please list any areas in which you have concerns. *
How do you maintain a daily relationship with Christ? *
In order to serve, would you need to arrive early or late? If yes, please explain. *
Have you carefully read the Important Details section of youngdisciple.org/counselor-application? *
Would you feel comfortable guiding a camper in establishing a personal devotional program? *
Would you feel comfortable leading out in unit worships? *
Are you willing to require 100% obedience from the campers in your unit? *
Could you take disciplinary measures with your campers, even if they might dislike you for it? *
Are you prepared to handle the strain of being responsible for campers around the clock? *
Are you willing, by God's grace, to give special attention to the "unlovable" campers in your unit? *
Can you adjust to the camp schedule without taking extra naps during the day? *
You may encounter problems during the week. In such a case, are you willing to bring them to your head counselor rather than to your parent(s), friends, or other staff members? *
Are you willing to enthusiastically accept whatever accommodations your unit is assigned, whether it is up to your expectations or not? *
Are you willing to accept responsibilities as assigned, even if they are not your first choice? *
Are you prepared to follow up with the campers in your unit by sending letters, cards, etc. throughout the year? *
Are you prepared to sit among your campers at meals and worships, even when you'd rather sit next to a friend? *
Are you willing to enthusiastically participate in every aspect of the camp program, even push-ups at line call? *
If you are selected as a counselor, will you carefully study the counselor handbook prior to camp time? *
Are you prepared to petition the Lord for His sweet spirit to keep you from criticizing, condemning, or complaining, and thus set a proper example for the campers? *

PARENT’S AUTHORIZATION
(For all minor applicants, under age 18.)

As parent and/or legal guardian of the applicant, I am in favor of the applicant serving at Young Disciple Youth Bible Camp and participating in all activities unless otherwise specified in writing. I hereby release the camp and its staff from liability in case of accident or illness, and I understand I am responsible for any charges incurred in treatment of my child's illness. In case of emergency, I understand an attempt will be made to contact me. I hereby give permission to the medical personnel selected by the camp directors to administer natural remedies as deemed appropriate and/or to hospitalize and administer anesthesia and medications as necessary, or perform surgery on my child. I also give permission for Young Disciple Ministries to use pictures taken of my child during camp for promotional and/or illustrative purposes.
Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I UNDERSTAND I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Parent/guardian signature

Clear
Name of parent/guardian

First Name Last Name
Relationship
Signature date

Month Day Year
Date
Counselor Agreement

I have carefully read the camp codes, and I agree to abide by all the camp regulations and policies, and to uphold camp objectives. I will not promote any issue or subject that will cause controversy, division, or discontent among the camp staff, campers, or visitors to the camp. I hereby release the camp from liability in case of accident or illness. I also give permission to Young Disciple Ministries to use images taken of me during camp for promotional or illustrative purposes.
Applicant signature *

Clear
Signature date *

Month Day Year
Date
Should be Empty:

2021 Counselor Application

Experience & Qualifications

Dates & Transportation

Medical and Emergency Contact Information

Camp Polo Shirt

References

Important Questions

Skills & Interests