Senior Counsellor Application Form

Senior Counsellor Application Form

Camp St. Basil's 2026
Applicant Information:

All new and returning counselors who are 18+ are required to complete this application form. New applicants whose applications meet the criteria of the Eparchy of Edmonton and St. Basil the Great Ukrainian Catholic Parish will be invited to participate in an interview with our directors. Final approval as a counselor for Camp St. Basil's 2026 will be granted following a successful interview.
Name

First NameLast Name
Birth date

MonthDayYear
Date
Age by June 28th, 2026
Gender
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Is this number a cellphone or a landline?
Email
example@example.com
We are a Catholic camp that offers programming with a focus on faith, but we welcome applications for counsellors from different backgrounds! Please tell us a bit about your relationship to the Ukrainian-Catholic church or any other religious group you belong to. No need to get in-depth or personal, we just like to gauge where our counsellors are when placing them in catechism-related activities. Please include if you belong to a religious community, and if so, which one?
Which language(s) are you fluent in? Please check all that apply:

Other

How did you hear about this volunteer opportunity?
What prior experience do you have working with children? Please expand on your roles or responsibilities (i.e. babysitter, taking care of siblings, extracurricular volunteering, coaching, etc).
What kind of camp-related experience do you have? This experience can be at Camp St. Basil's, Camp Oselia, or any other type of camp. Please describe it in detail (considering your roles as a camper, volunteer, etc).
Please write a brief description of yourself. Remember to include information on your personality, hobbies, work, and volunteer experiences. List any skills that you feel would be an asset to our camp environment (i.e. drama, sports, music, academic). Also include any specialized training and certifications (i.e. First Aid, Lifeguard, CPR, Babysitting, etc) that you feel would benefit our camp setting.
If you have any additional comments, questions, or concerns, please include them below:

Health and Emergency Information
Emergency contact's name:

First NameLast Name
Relationship to applicant:
Phone number of emergency contact:
Please enter a valid phone number.Format: (000) 000-0000.
Applicant's Provincial Health Care Number:
If you don't have one or are waiting for one please type "Don't have one"
Province of healthcare:
You DO NOT need to disclose personal information unless you think it would be pertinent to your health and safety in our camp environment, wherein a registered nurse will be present.

Please describe any allergies, illnesses, behavioural and/or medical conditions that you would like our nurse to be aware of in the case of an emergency.

ALTERNATELY you may speak with the nurse directly while at camp if you do not want your information to be recorded in this form.
HOWEVER if you have any relevant food allergies, please do include them here to aid our kitchen staff in accommodating your needs.

Permissions and Releases
Photo and Media Release

Camp St. Basil's takes photos and videos of all people participating in our camps for our records and for possible promotional purposes. However, we will not publicly publish them without your permission.

From time to time, we may take photos or videos during camp to capture activities and share the experience with our community.

By signing below, the undersigned gives permission to be photographed, filmed, and/or recorded while participating in the program.

These images and recordings may be used by the organizers for promotional and informational purposes, including on our website, social media, and in print or digital materials related to the program.

We may edit or use these images as needed, and they will remain the property of the organizers. No compensation will be provided for their use.

By consenting, the undersigned also agrees to release and hold harmless the organizers, staff, volunteers, and affiliated parties from any claims related to the use of these images or recordings, except where prohibited by law.

Confirmation

BY SIGNING BELOW, I AM PROVIDING MY OWN CONSENT AND 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.
May we publish photographs or videos of you as you participate at Camp St. Basil's for positive promotional and fundraising purposes, such as in our camp website, parish websites, brochures, and other promotional and fundraising materials?
Signature:
Informed Consent and Acknowledgement

I hereby give my approval for my participation in any and all activities prepared by Camp St. Basil's during the selected camp. In exchange for the acceptance of my volunteer candidacy by Camp St. Basil's, I assume all risks and hazards incidental to the conduct of the activities, and release, absolve, and hold harmless Camp St. Basil's and all its respective officers, agents, and representatives from any and all liability for injuries to myself arising out of traveling to, participating in, or returning from selected camp sessions.

In case of injury to myself, I hereby waive all claims against Camp St. Basil's, including all staff members, volunteers, and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event.

I understand that there is a risk of injury inherent in all activities, including sports and other camp-related activities, and I voluntarily accept these risks.

Confirmation

BY SIGNING BELOW, I AM PROVIDING MY OWN CONSENT AND 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.
Signature:
Medical Release and Authorization

I hereby authorize the diagnosis and treatment of myself by a qualified and licensed medical professional in the event of a medical emergency which, in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of my life, physical disfigurement, physical impairment, or other undue pain, suffering, or discomfort if delayed.

Permission is hereby granted to the attending physician to proceed with any necessary medical or minor surgical treatment, X-ray examination, and immunizations.

Permission is also granted to Camp St. Basil's and its affiliates, including directors, counsellors, and others, to provide reasonable emergency assistance prior to my admission to a medical facility.

This authorization is effective for the dates and duration of the registered camp.

This release is given and executed of my own free will for the purpose of authorizing emergency medical treatment for myself.

Confirmation

BY SIGNING BELOW, I AM PROVIDING MY OWN CONSENT AND 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.
Signature:
Responsibility for Property Damage

The undersigned acknowledges and agrees that they are responsible for their own conduct.

The undersigned agrees to assume full financial responsibility for any loss, damage, or destruction of property caused by their actions, negligence, or willful misconduct while participating in or attending the program, whether on or off the premises.

The undersigned further agrees to indemnify and hold harmless the organizers, staff, volunteers, and facility owners from any costs, expenses, or claims arising from such damage.

This provision applies to all property, including but not limited to facilities, equipment, and the property of other participants.

Assumption of Risk and Personal Property

The undersigned acknowledges that attendance at the program and presence on the premises involves inherent risks. The organizers, staff, volunteers, and facility owners are not responsible for any personal injury, loss, or damage to personal property belonging to the undersigned, except where such loss or damage is directly caused by the gross negligence of the organizers.

Right to Refuse or Remove

The organizers reserve the right, at their sole discretion, to refuse entry to or require the departure of any participant whose behavior is deemed inappropriate, disruptive, or unsafe, without refund.

Confirmation

BY SIGNING BELOW, I AM PROVIDING MY OWN CONSENT AND 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.
Signature:

Thank you for taking the time to apply to be a Senior Counsellor at Camp St. Basil's! We look forward to reading your application, and will respond as soon as possible.

In the meantime, feel free to take a look through our website! Information regarding packing, directions, etc will become available on our website closer to the date of camp.

If you have any other questions, comments, or concerns, don't hesitate to email us at campstbasils@gmail.com

Please review the form to make sure all of your information is correct and then submit!
Should be Empty:

Senior Counsellor Application Form

Health and Emergency Information

Permissions and Releases