Vasa Youth Day Camp Counselor/CIT Application 2025 We must receive the completed application form no later than June 1st Camp Dates: July 28th through August 1st 2025

Please provide the name and phone number of an adult reference (no relatives) Include area code.

Counselors and CITs are required to be at Vasa Park by 8:30 a.m. each day of camp and stay until camp is over and the area is cleaned up. On Friday evening, all counselors/CITs are required to stay until the preparation for the dinner and camp program are finished. It is also required for all counselors/CITs to return to Vasa Park no later than 5:30 p.m. for the program. Everyone must stay to help clean up the kitchen and the park after the program.

By signing and submitting this application, I agree to follow park rules, camp rules, and directions of the adult leaders of Vasa Youth Day Camp. I understand that if I am selected as a counselor or CIT, I am required to attend an orientation at Vasa Park on Sunday, July 27th from 1:00 p.m. until approximately 3:00 p.m. If I fail to attend orientation, I understand that I forfeit my position as CIT or counselor.

I give permission for my child to participate in all activities as part of the Vasa Youth Day Camp.

I hereby give permission that my child may be given emergency treatment by a qualified staff member of Vasa Youth Day Camp.  I also give permission for my child to be transported by ambulance, treated by aid car personnel, and/or transported to an emergency center for treatment.

In the event that I cannot be contacted, I further consent to the medical, surgical, and hospital care, treatment, and procedures to be performed for my child by a licensed physician or hospital selected by the Camp Coordinators when deemed necessary or advisable by the physician to safeguard my child’s health. 

Photographs of counselors and counselors in training may be used for advertising Vasa Youth Camp.  I give permission for photos of my child to be used for this purpose.

HOLD HARMLESS AGREEMENT:

I, 

, the undersigned parent/guardian of

do hold Vasa Youth Day Camp harmless for any loss, liability or expense incurred during his/her participation beginning  July 27th, 2025 through August 1st, 2025.

 

I have read and understand the above Authorizations and Agreement and have completed the information to the best of my ability.