Returning Counselor Application 2025

Returning Counselor Application 2026

Please enter your information below.
General Information
Name*

First nameLast name
Birth date*

MonthDayYear
Current age*
MaleFemale
Email*
example@example.com
Cell phone
Format: (000) 000-0000.
Home phone
Format: (000) 000-0000.
Mailing address*

Address line 1

Address line 2

CityState / Province

Zip / Postal CodeCountry
Current occupation/grade in school*

Dates & Transportation
July 6–8: Camp Prep Workbee
July 8–12: Counselor Orientation
July 12–19: Camp Week 1
July 19–26: Camp Week 2
July 26–28: Counselor Retreat
July 28–30: Camp Cleanup Workbee
I plan to be at Young Disciple Camp from July 8–26 (not staying for the counselor retreat).I plan to be at Young Disciple Camp from July 8–28 (staying for the counselor retreat).I plan to help with camp prep (give arrival date below).I plan to help with camp cleanup/tear down after counselor retreat (give departure date below).I will need to be picked up at the airport. I will provide the camp office with all flight details.*I will provide my own transportation to camp.I will bring a vehicle to camp that I can use for camp transportation and I can transport campers to nearby functions (give number below).I am willing to allow another licensed driver to use my vehicle for camp purposes.Other (specify below).
Arrival date for camp prep (e.g. "Monday, July 6")
Departure date from camp cleanup
Number of campers you can transport if needed:
Other travel arrangements
* Young Disciple provides airport pickup and drop-off service for those whose flights arrive at Spokane International Airport by 2:30 pm on July 8, and depart after 1:00 pm on July 26, or anytime within reason on July 28. Please send a copy of your flight itinerary to the YD office at least three weeks prior to camp.

Skills
Please list any new skills or interests* you have that may benefit the camp program.
Please list any classes you are able to teach.
* If you would like some ideas of what we're looking for, see the bottom of the Counselor Information page on youngdisciple.org to refer to a list of skills & interests given in the first-time counselor application.
Camp Polo Shirt

If your current camp polo shirt looks nice and is in good condition, please be sure to bring it and do not select a size below. If you need a replacement polo shirt, please select the size you would like:
SMLXLXXL

Medical Information
Please list any significant physical conditions or medical history (major surgery, seizures, mental/emotional illness, etc.)
Describe any significant allergies you have to foods, medications, and other substances you might encounter at camp. Please also list your reaction and preferred treatment.
YesNo
Medical insurance carrier
Policy number
Emergency Contact
Emergency contact name*

First NameLast Name
Relationship*
Phone number*
Format: (000) 000-0000.

PARENT’S AUTHORIZATION
(For all minor applicants, under age 18.)

As parent and/or legal guardian of the applicant, I am in favor of the applicant serving at Young Disciple Youth Bible Camp and participating in all activities unless otherwise specified in writing. I hereby release the camp and its staff from liability in case of accident or illness, and I understand I am responsible for any charges incurred in treatment of my child's illness. In case of emergency, I understand an attempt will be made to contact me. I hereby give permission to the medical personnel selected by the camp directors to administer natural remedies as deemed appropriate and/or to hospitalize and administer anesthesia and medications as necessary, or perform surgery on my child. I also give permission for Young Disciple Ministries to use pictures taken of my child during camp for promotional and/or illustrative purposes.
Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I UNDERSTAND I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Parent/guardian signature

Clear
Name of parent/guardian

First nameLast name
Relationship
Signature date

MonthDayYear
Date
Counselor Agreement

I have carefully read the camp codes, and I agree to abide by all the camp regulations and policies, and to uphold camp objectives. I will not promote any issue or subject that will cause controversy, division, or discontent among the camp staff, campers, or visitors to the camp. I hereby release the camp from liability in case of accident or illness. I also give permission to Young Disciple Ministries to use images taken of me during camp for promotional or illustrative purposes.
Applicant signature*

Clear
Signature date*

MonthDayYear
Date
Should be Empty:

Returning Counselor Application 2026

Dates & Transportation

Skills

Camp Polo Shirt

Medical Information