Camp Jack Jr. Counselor Application

Camp Jack Jr. Counselor Application
Thank you for your interest to serve at Camp Jack!

Application Process
1. Commit to serving a weeklong commitment from June 28-July 3, 2026
2. Complete and submit the Camp Jack Jr. Application
3. Meet with Laurie Mikolaycik, Camp Jack Director
4. Complete and submit the Camp Jack Jr. Permission Form
5. Complete and submit the Lake Cuyamaca Boat Waiver
This application is for volunteers under the age of 18. If you will be age 18 by June 28, 2026, please complete the Camp Jack Paid Counselor Application.
Jr. Counselor Information
YesNo
Counselor Name*

First NameLast Name
Counselor Email
example@example.com
Counselor Phone Number
Format: (000) 000-0000.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of Birth:*

MonthDayYear
Date
T-shirt Size:*
Gender:*
School Name* Grade*
YesNo
Please share how being a Camp Jack Jr. Counselor would be a ministry opportunity to be a servant leader - rather than just a summer activity?*

Jr. Counselor Information