Counselor Registration

ALL Counselor applicants need prior approval from the Session Director.
Counselor Information

Please complete ALL questions.
Counselor's Name

First NameLast Name
Gender
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
Email
example@example.com
I am applying to serve as a:

Select counselor position and session number.
Select Counselor position
Select .
Select Session
Select Session Attending.
I have spoken to the Session Director and gotten approval to be a counselor.
Background Check

ALL counselor's, Cooks, and Session Staff are required to complete a back ground check in order to participate in a camping session.
Full Legal Name

First NameMiddle NameLast Name
Birth Date:

MonthDayYear
Date
Driver's License Number
Please enter your number and State
Camp T-Shirt

A t-shirt is included in the registration fee. Please select the desired size for your camper.
Camper T-Shirt Size
Emergency/Alternate Contact Information
Emergency Contact's Name

First NameLast Name
Relationship
Phone Number

Area CodePhone Number
Photo/Video Release

If given permission, we may use your camper's image for publicity purposes.
I allow camp use photos/videos.