CCL Summer Camp Counselor Application
Summer Camp Counselors are entering 9th-12th grade in the fall. Those younger should look into being CITs. If you will have already graduated high school, consider applying to be an Intern.
Basic Info
Applicant Name
*
First Name
Last Name
Email
*
example@example.com. If you don't have an email address, please enter your parent/guardian's email address
Cell Phone
*
Please enter a valid phone number. If you don't have a cell phone, please enter your parent/guardian's email address
Birthday
*
/
Month
/
Day
Year
Date
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Fall 2022 Grade
*
9
10
11
12
School attending
*
Please list any medical or special concerns we should be aware of:
*
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Emergency Contacts
Parent/Guardian 1 Name
*
First Name
Last Name
Parent/Guardian 1 primary phone number
*
Please enter a valid phone number.
Parent/Guardian 1 email address
*
example@example.com
Is parent/guardian 1 address the same as applicant's?
*
Yes
No
Parent/Guardian address (if different from applicant)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Would you like to add an additional parent/guardian?
*
Yes
No
Parent/Guardian 2 Name
*
First Name
Last Name
Parent/Guardian 2 primary phone number
*
Please enter a valid phone number.
Parent/Guardian 2 email address
*
example@example.com
Is parent/guardian 2 address the same as applicant's?
*
Yes
No
Parent/Guardian 2 Address (if different from applicant)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Name of Emergency Contact if parent/guardian is unavailable
*
First Name
Last Name
Phone Number of Emergency Contact
*
Please enter a valid phone number.
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Tell us a little bit about you!
*
What is motivating you to work at CCL Summer Camp?
Briefly describe your faith (this could be what you believe, what your spiritual practices are/devotional life, if/where you attend church, etc.)
Areas of Interest (check all that apply)
*
sports/recreation
puppets
drama
arts & crafts
cleaning
kitchen/snacks
Other
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Availability
Please select the weeks of camp you would be interested in working. It is preferred that you commit to a full week of camp, rather than partial weeks/singular days.
Mark the weeks of camp you are interested in working:
*
I can work
I cannot work
unsure
Week 1 (5/30-6/3)
Week 2 (6/6-6/10)
Week 3 (6/13-6/17)
Week 4 (6/20-6/24)
Week 5 (6/27-7/1)
Week 6 (Tuesday 7/5-7/8)
Week 7 (7/11-7/15)
Week 8 (7/18-7/22)
Week 9 (7/25-7/29)
Anything else we should know?
Signature
By typing you're name, you are acknowledging that you are the parent/ legal guardian of the minor listed above and that you have read, accept, and understand all the contents in this electronic agreement. You agree your electronic signature is the legal equivalent of your manual signature on this form.
Clear
Submit
Should be Empty: