In accordance with the Children's Online Privacy Protection Act a person must 
be 13 years of age or older to complete and submit forms from this site.

Please put a check next to each camp that you would like to receive your
application

Name:  
E-Mail:  
Address:  
City:         
State/Country: 
Zip:       
Phone:  

School Attending:  
Year in School:High School SeniorCollege FreshmanCollege SophmoreCollege JuniorCollege SeniorGraduate ProgramAdultTeacher         

Position Sought:SupervisorGroup LeaderCounselorGroup CounselorHead CounselorActivity SpecialistKitchenOfficeWebsiteLifeguardNurseDirectorAssistant DirectorMaintenanceSecurity Minimum Acceptable Salary:  

Certifications:
WSI
Lifeguard
CPR
EMT
1st Aid
Multiple items may be chosen.

List Activities you feel qualified to Lead/Assist in order of your Qualifications
Activity 1:   
Activity 2:   
Activity 3:   
Activity 4:   
Activity 5:   
Activity 6:   
Activity 7:   
Activity 8:  
        

Please state or expand upon any special qualifications you may have for working with children or for 
particular activities (ex. Varsity sports, special achievements, experience working with children).