Staff Registration

ALL Cooks/Lifeguards need prior approval from the Session Director.
Camp COOK / NURSE / LIFEGUARD Information

Please complete ALL questions.
Name*

First NameLast Name
MaleFemale
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

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

Select staff position and the session number.
Select staff posititon*
Select .
Select Session*
Select Session Attending.
YES
Background Check

ALL camp 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

If you would like to purchase a T-Shirt please select desired size.
If you DO NOT want to purchase a T-Shirt select "NO T-SHIRT NEEDED".
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 the staff's image for publicity purposes.
YesNo
PAYMENT

Please select the appropriate form of payment.

Camp T-Shirt

T-Shirt$15.00

Subtotal $0.00Shipping $0.00Total $0.00

Camp COOK / NURSE / LIFEGUARD Information