Name
*
Email
*
Phone number
*
Birthdate
*
T'Shirt Size
*
XS
S
M
L
XL
XXL
Which week(s) are you applying for?
*
July 6th - 10th
July 27th - 31st
Are you available for all camp dates for that week?
*
Yes
No
If the above is No, please explain your availability...
What is your current school or employer?
*
What is your role/ Major/ or Position there?
*
Do you have any certifications?
*
CPR
First Aid
Teaching
None
Have you ever been convicted of a felony?
*
No
Yes
If Yes, please explain.
Submit
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