Counsellor Application Form Logo
  • Counsellor Application Form

  • General Information

    Camp Dates

    • Intermediate Camp for Grades 4-7 | July 7-11
      • Counsellors must be between the ages of 14 and 17 years old
    • Junior Camp for Grades 1-3 | July 14-18 Counsellors must be between the ages of 13 and 17 years old

     The application deadline is May 21, 2025.

    • Counsellor Training: May 31, 2025, 8:30 am – 4:30 pm. 
      • Attendance Required.
    • Plan to Protect - Online Abuse Prevention Training: June 7, 2025 - Morning and Afternoon sessions are available.
    • Counsellors' Camp Day: July 4, 2025, 10:00 am - 2:00 pm.

    The following application is to be completed and signed by both the applicant AND a parent/guardian.

    All Counsellors must arrange their own transportation to and from camp.

    Information received is confidential and is being gathered for the purposes of screening program personnel. The information gathered here will be used for the purposes of supporting the programs at SBCC.

    If you have any questions or concerns, please contact Marylie Svendsen 780-214-9570.

  • Questions for Perspective Counsellors:

    Respond to each question with a brief description
  • References

    We will be checking references. Please list 2 adults that you have known for at least one year and who have a definite knowledge of your character and ability to work with children. Potential references may be your priest, employer, or teacher.
  • Parent/Guardian Information

  • Parent/ Guardian #2 Information

    (Optional)
  • Note: Your parents/ guardian will be copied on all correspondence you receive from camp personnel.

    If your parent/ guardian is interested in volunteering, please have them complete a volunteer form.

  • Emergency Contact Information

    (Other than parent/ guardian)
  • Medical Information

  • Medical Authorization and Administration Information

  • If medication is required, please complete the following medical authorization and administration information:

    • All prescription medications are to be left with the designated first aid personnel along with detailed instructions.  All medications will only be administered by the designated first aid personnel.
    • This record will be kept in the child’s file.  Any medical information collected here serves to authorize the Director of Camp Operations or designated first aid personnel to obtain medical assistance in emergencies.
  • Name of Medication: Dosage:

  • Start Date:End Date:
    Storage Instructions:
    Administration Instructions:
    Prescribing Physician: Phone Number:
    STOP the medication/treatment if:

  • Name of Medication: Dosage:

  • Start Date:End Date:
    Storage Instructions:
    Administration Instructions:
    Prescribing Physician: Phone Number:
    STOP the medication/treatment if:

  • Name of Medication: Dosage:

  • Start Date:End Date:
    Storage Instructions:
    Administration Instructions:
    Prescribing Physician: Phone Number:
    STOP the medication/treatment if:

  • Informed Letter of Consent for Parents/ Guardians of Campers

    We are planning the following activities as part of our programming that requires your permission prior to participation. We have provided you with the details of the activity and request your consent. The safety of your child is our primary concern. Precautions will be taken for their well-being and protection.

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  • I hereby consent to the participation of my/our child(ren) in this supervised activity.

    While every precaution is taken for the safety and good health of all participants, some sports and activities carry with them the inherent risk of personal injury beyond the risks associated with many of the recreational activities at camp.  I/we understand and accept these risks and agree that by allowing my child to participate in those activities, he/she may be taking part in a recreational activity that presents the potential for personal injury.

    I/we, the parents or guardians named below, authorize the Director of Camp Operations or a designated SBCC representative to sign a consent for medical treatment and to authorize any physician or hospital to provide medical assessment, treatment or procedures for the participant named above.

    I/we, named below, undertake and agree to indemnify and hold blameless SBCC, its program personnel and its Board of Directors from and against any loss, damage or injury suffered by the participant as a result of being part of the activities of SBCC, as well as of any medical treatment authorized by the supervising individuals representing SBCC.  This consent and authorization is effective only when participating in or travelling to and from events of SBCC.

  • Confidentiality Statement

    I understand that I will obtain or have access to sensitive and confidential information in my role as a counsellor with SBCC.  That confidential information may include, without restriction, personal information regarding paid personnel, volunteers, members, attendees, supporters or persons participating in the SBCC camp program including information relating to donations, personal or family matters, or obtained from background screening of prospective program personnel.  I agree to maintain strict confidentiality of all such confidential information and I will not disclose such information to anyone (including paid personnel, volunteers, members, attendees, supporters, persons participating in the SBCC camp program, or my spouse or family members) except authorized representatives of SBCC who need to know such information or as required by law.  I understand and agree that confidentiality is very important in my role and critical to the effective functioning of the camp.  If I become aware that any confidential information was improperly disclosed, I will immediately advise the Director of Camp Operations.

  • Covenant of Care for Counsellors

  • I will read, understand and agree to comply with all the SBCC policies and procedures (provided at the counsellor training) to protect the health and safety of campers at all times and commit to care for those placed in my trust. 

  •  I also acknowledge the paramount importance of safeguarding (in all respects) all of those with whom we work, especially campers, by:

    ● being committed to growing in every area of my life through engaging in various practices and experiences that keep me connected to God and becoming more like Christ.

    ● complying with the information given in my training

    ● attending mandatory training including Plan to Protect online abuse prevention training

    ● using appropriate language;

    ● following the Code of Conduct

    ● providing an environment that respects human dignity in keeping with the teaching of the Roman Catholic Church

    ● respecting confidentiality/ privacy, unless a camper is in danger, in which case notify the facilitators.

    In addition to any duties written in the Counselor Code of Conduct, I accept the following responsibilities as part of my job description: 

    ● participate in morning meetings with facilitators to prepare for the day

    ● greet my camp family upon arrival and see them off at the end of the day

    ● ensure that all camp family members are participating and feel included

    ● ensure that all camp family members are well prepared for outside activities i.e. sunscreen, hats, water etc.

    ● contact facilitator if any behavior problems arise or if unsure as to how to problem-solve

    ● be willing to share responsibilities with my co-counselor and problem-solve if any conflict arises

    ● participate in wrap up meetings by giving positive feedback or identifying problems

    ● if unable to fulfill my duties, inform facilitators well in advance

    ● actively participate in camp activities with my campers i.e. singing, praying, swimming, canoeing, playing games etc.

    ● maintain an appropriate level of control of my camp family throughout the day i.e. during meals, transition between activities etc.

    ● ensure that my camp family arrives on time, as scheduled, for each activity

  • Counsellor Code of Conduct

    1. Close, personal relationships/touching/actions/words: know your boundaries. You are being put into a position of trust. Avoid the perception of inappropriate physical contact i.e. piggyback, wrestling. These are safety issues as well.

    2. Name tag:  you will be given a name tag the first day of camp.  You must wear this name tag at all times.  It is important that everyone know who you are and that you are part of the camp family.

    3. Attendance: counsellors will take attendance of campers in their camp family at every transitional activity.

    4. Cell phone usage: NO cell phones, taking photos, texting, music and other electronic devices are permitted.                                                                

    5. During camp day: please leave your phone in your bag before counsellor meeting starts in the morning and retrieve after counsellor meeting ends at the end of the day.  Your responsibility is to be focused on your campers the whole time that they are there. Counsellor meetings are for you to discuss your day, problem-solve and share positive experiences.  The campers should not have cell phones - neither should you!  Facilitators need to have access to personal cell phones for communication purposes.  It is part of their job. 

    6. Illegal substances: no drugs, alcohol etc. References to illegal substances shall not be made to campers or other counsellors.

    7. Modest dress code: you are a role model for young children.  Please dress modestly i.e. longer shorts, camp t-shirts every day, appropriate symbols and wording only on your clothing, bathing suits - no bikinis, no speedos

    8. Getting changed: only 1 camper or 1 counsellor at a time in a change room.  Washrooms are not to be used as change rooms.

    9. NO camper is to be alone with an adult/counsellor at any time.

    10. Organization of campers: you are responsible for helping campers stay organized throughout the day.

    11. Counsellors are expected to be at camp by 8:20 a.m. EVERY morning (unless told differently) and are expected to stay at camp until clean up and preparations for the next day are completed.

    12. You are expected to arrange your own transportation to/from camp.

    13. All counsellors must attend counsellor trainings.

    14. I understand that I need to be a responsible and mature leader; I will take direction from camp facilitators and Director of Camp Operations.

    15. I understand that camper safety and well-being are my first priority.

    16. Working at camp is fun but it is still work.

    17. Counsellors are not to contact campers outside of camp program hours.

    18. Camp counsellors are volunteers. You can use your volunteer hours at camp for 'service hours’ for next year’s Christian Ethics class.

  • Counsellor Behaviour Expectations and Disciplinary Procedures

    (includes Anti-Bullying Policy and Zero Tolerance Policy)
  • Please review with your child:

    SBCC strives to provide children and youth of the community with an opportunity, in a camp setting, to grow in their love for God, His people and all creation and to grow in their knowledge of the teachings of the Catholic Church.  

    We believe all counsellors should treat others with courtesy, comply with the rules for each activity and conduct themselves appropriately.  We want to create a positive and inclusive atmosphere for all our participants in order for them to have a right to a caring, safe, respectful camp environment.

    For the safety of all our participants and program personnel, it is necessary that we, the Board of Directors of SBCC, enforce and consistently follow through with rules and disciplinary procedures. 

    An anti-bullying policy will therefore be in effect at all times and will be clearly communicated and enforced among participants and all program personnel.  All program personnel will take action to prevent bullying, teach against it, and assist and support counsellors who are being bullied.  Bullying in any form will not be tolerated.

    Bullying will be defined as unwanted, aggressive behaviour that involves a real or perceived power imbalance and is repeated or has the potential to be repeated.

    Types of Bullying:

    ●       Verbal Bullying

    ●       Social Bullying

    ●       Physical Bullying

    ●       Cyber Bullying

    ●       Racial Bullying

    ●       Homophobic Bullying

    ●       Sexual Harassment

     

    Procedure for Dealing with Bullying:

    Any incidents, reports or suspicions of bullying will be acknowledged, reviewed and dealt with appropriately and immediately. All incidents, reports or suspicions will be reported immediately to the facilitators.

    Appropriate action will take place based on the situation. Possible actions may include, but is not limited to:

    ●       Complete an Incident Report after each incident

    ●       Notify both sets of parents/guardians after each individual incident

    ●       Provide a warning that bullying will not be tolerated

    ●       Suspension for one day/event if bullying persists

    ●       Suspension for three days/events after next incident

    ●       Prohibit the counsellor from participating if the bullying does not stop

    ●       If necessary/appropriate, contact and consult with police.

    All attempts will be made to work towards reconciliation and change of behaviour with the person who is bullying.

    Our progressive discipline process consists of three levels or three warnings.

    Action taken at each level will be recorded with the counsellor’s name, the incident and any information regarding the behaviour on the Incident Report. 

    Please note:

    · Depending on the severity of the situation, progressive discipline warnings may be skipped over to the next warning.

    · Disciplinary reports will be kept on file by SBCC. 

    Disciplinary procedures will consist of a Progressive Discipline process as listed below.

    Warning Level One

    If a counsellor is continually not listening, not following the rules and/or misbehaving: having been spoken to several times by a person in a position of authority, he or she will receive 3 verbal warnings before parents/guardians are notified of the situation by a facilitator.

    The parent/guardian will be contacted by the facilitator, informed of the inappropriate behaviour and requested to discuss the inappropriate behaviour with the counsellor.

    Within “Level One”, behaviour is from mild to moderate (refer to the table below for examples of behaviour).

     

    Warning Level Two

    If a counsellor is continually making inappropriate slurs, racial or threatening remarks or is swearing, leaving an activity without permission, being defiant etc. or if the first level of discipline has been issued, parents/guardians will be notified by the Director of Camp Operations of the inappropriate behaviour. It will be noted that this is a Level Two warning.

    The Director of Camp Operations will contact parents/guardians to discuss the behaviours and actions to be taken.

    The counsellor may be denied attendance at camp for one day.  

    Within “Level Two”, behaviour is from moderate to severe (refer to table below for examples of behaviour). 

     

    Warning Level Three

    In the case of extreme inappropriate behaviour, for instance, if the counsellor has hit, punched, bitten, and/or attacked a camper or any program personnel, he or she will skip the first and second levels and receive a Level Three warning.  If the first and second levels of discipline warnings have been issued for previous behaviour, he or she will receive a Level Three warning. 

    The Director of Camp Operations will contact the parent /guardian immediately.  Parent/guardian will be required to pick up the counsellor.  The counsellor will not be able to continue his/her participation in the camp program for the current year.

    Within “Level Three”, behaviour is severe (refer to the table below for examples of behaviour).

     

    Examples of Mild-Moderate Offences (among others)

    Level One


    ● Rude gestures or comments, talking back repeatedly

    ● Not following rules or not listening when participating in games, swimming, canoeing, crafts, other activities

    ● Not listening to instructions

    ● Name-calling

    ● Disrespectful behaviour

     

    Examples of Moderate- Severe Offences (among others)

    Level Two


    ● Any mild recurring offences that continue after receiving yellow form

    ● Degrading behaviour

    ● Continuing to demonstrate offensive behaviours even after reminders have been given

    ● Refusing to participate

    ● Leaving the activity without permission

    ● Defiance

     

    Examples of Severe Offences (among others)

    Level Three


    ● Any violent act which harms any participant or program personnel

    ● Repeated degrading behaviour

    ● Any recurring offences that continue after receiving the orange form

    ● Stealing

    ● Kicking, biting, punching swearing

    ● Vandalism to facility equipment or property

  • Release of Information and Declaration of Intent

    I hereby give SBCC permission to contact persons named by me above as references to gather information in order for SBCC to decide whether I am suitable for camp work.

    I hereby give SBCC consent to verify the information provided by me in this Counselor Application Form and to contact the references to obtain and verify any information from them (and any other persons that SBCC determines might be able to provide relevant information) that may be relevant to my application.

    I will sign the “Release of Information and Declaration of Intent” for such purpose.

    I further grant SBCC permission to perform an internet search on me and to review and consider any information found about me on the Internet.

    I understand that if SBCC approves my counsellor application and later determines, in its discretion, at any time that I am not suitable for service with SBCC or for the position for which I am applying, SBCC may terminate my service/position for any reason without advance notice.

    If SBCC approves my application for a counsellor position, I will sign any documents that SBCC requires and will at all times cooperate fully with the program personnel of SBCC in the fulfillment of my duties and will keep all confidential information I encounter in my role as a counsellor, confidential.

    If at any time, I determine that for any reason I am unable to support or adhere to or follow the policies, procedures or doctrine of SBCC, I will inform SBCC and will resign my position.

    Information collected by SBCC will be maintained indefinitely as it is a requirement of our insurance company and legal counsel. If you wish SBCC to limit the information collected or to view your child’s information, please contact us.

    I hereby acknowledge that, to the best of my knowledge, the information contained in this Counselor Application Form is true and correct.

  • General Waiver

    To: Sandy Beach Community Camp Inc (the “Release Party”)

    IN CONSIDERATION of the release party allowing me and/or my child or children to attend the summer camp organized by SANDY BEACH COMMUNITY CAMP INC. and participating in certain activities while at camp such as hiking, camping, canoeing, swimming, basketball, volleyball, dodgeball, tag, and other activities, (the “Camp Activities”) involving lands rented by the “Release Party”:

    I ACKNOWLEDGE that some of the “Camp Activities” are inherently dangerous and contain a risk of serious injury or death; and that supervision is not assurance that I, or my child or children, will not suffer injury or death.

    I CONSENT to myself and/or my child or children attending Sandy Beach Community Camp Inc. and participating in the “Camp Activities” in spite of the risks involved in participating in those activities.

    THE UNDERSIGNED for myself, my heirs, successors and assigns, HEREBY RELEASES AND FOREVER DISCHARGES the “Release Party”, as well as the “Release Party’s” executors, administrators, successors and assigns from any and all actions, causes of actions, liabilities, costs, claims and demands whatsoever at law, in equity or under any statute which we ever had or now have or which its successors and assigns may have, by reason of any matter, cause of thing whatsoever arising out of or in any way related to our attendance at the camp or involvement with the “Camp Activities”.

    THE CONSIDERATION stated herein is the sole consideration.  I make this release and indemnity intending that it be legally binding.  IN WITNESS WHEREOF I have set my hand and seal on this day. 

    The safety of your child is our primary concern.  Precautions will be taken for their wellbeing and protection.

    Please note: SBCC is only responsible for your children during camp program times.

  • Transportation

  • Privacy Policy

    Please review the SBCC Privacy Policy.

  • Confirmation BY ACKNOWLEDGING AND SIGNING BELOW, 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.

    • Medical Authorizations
    • Informed Letter of Consent
    • Counsellor Code of Conduct
    • Counsellor Behavior Expectations and Disciplinary Procedures
    • Release of Information and Declaration of Intent
    • General Waiver
    • Privacy Policy
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    • Confidentiality Statement
    • Covenant of Care for Counsellors
    • Counsellor Code of Conduct
    • Relase of Information and Declaration of Intent
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