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Camp Navarro Counselor Application

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					             Camp Navarro New Counselor Application
Name ___________________________________                   Phone ____________________

Address ____________________________________________________________
                                                                          (Include zip code)
Mailing Address (if different than above) ______________________________________
__________________________________________________________________

Email Address _______________________________________________________

School ____________________            Grade ______ Date of Birth ______ Age ____

Required Dates of Counselors:
To be a camp counselor you MUST be present for the following dates:
   - Initial Counselor Meeting: Thursday January 18th 2010, 7pm LaTercera Multi Purpose Room
   - Counselor Interviews: Sunday February 25th 2010, LaTercera Room E3 9am
          o (Interviews begin at 9am every hour on the hour after (prospective counselors will
             sign up for a 1 hour interview)
   - Counselor Pre-Camp Training: Friday April 20th, LaTercera 4:30-7:30pm
   - Week of Camp: Saturday May 5th – Saturday May 12th 2012

Can you attend these meetings?:    ___ Yes       ___ No
   - If no please list which meetings you CAN attend: _________________________

Please list any conflicts with the week of camp such as Prom, sports playoffs, etc.:
_________________________________________________________________

Academic Clearance
If in high school are you aware you must receive clearance from your school in order to
attend camp as counselor? Yes ______ No ______

Certifications
Please mark all you are certified in: (none are required to be eligible as a camp counselor)
__ CPR   __ First Aid    __ Bilingual (Please specify which language(s)) ____________

___ Epipen Certified    ___ First Responder Certified ___ EMT Certified

Other Certifications: __________________________________________________


Skills and Talents
Please mark all you feel you can bring to camp:
__ Sports __ Arts and Crafts __ Hiking __ Theatre      Other: __________________
Have you had any experience working with kids? (classroom aid, other counseling

experience, day care, church camps, boy/girl scouts etc.) _______________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________


What life skills can you bring to camp to teach the kids? _______________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________


Why do you want to go to camp Navarro?____________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________


Do you understand that as a camp counselor you are responsible for the safety and well
being of the campers for an entire week? Additionally, the role of a counselor involves
you being a role model outside of camp which includes some of the following behavior: not
wearing a Camp Navarro shirt in any situation where tobacco, alcohol or unlawful drugs
are involved as well as not putting camp pictures WITH KIDS on any social networking
website such as Facebook or Myspace, etc.?

____ Yes Please sign your name: ________________________________________
                  Old Adobe Union School District
                    Sixth Grade Camp Navarro

                            Counselor Pledge Sheet

  1. I will obey any specific rules that the individual school has written out or explained
      to me.
  2. I will not bring or use any tobacco, alcohol or unlawful drugs.
  3. I will not bring or use any firearms, fireworks, knives, radios, or other devices,
      which may cause injury or create a disturbance to others.
  4. I will not engage in profanity, vulgarity, or other inappropriate verbal behavior.
  5. I will respect the rights and differences of all people attending the camp.
  6. I will comply with the wishes of the teachers on specific ways they want their
      program carried out
  7. I will be responsible for leading the students as they fulfill their responsibilities.
  8. I will refrain from inappropriate behavior for this type of activity. I am a role
      model.
  9. I will not physically punish or verbally abuse a child though I have a right to set
      limits with my own group. I will report any inappropriate behavior.
  10. I understand that I legally do not have the right to post any photos from camp
      WITH KIDS on websites such as Facebook, Myspace, etc.
  11. I understand that it is inappropriate to accept friend requests from campers on
      social networking sites such as Facebook, Myspace, etc.
  12. I understand that in wearing my camp shirt, when outside of camp, I am still
      representing the camp, the organization and my fellow counselors.
  13. I understand that I not only represent camp but also the Old Adobe Union School
      District.

Date: __________________ _________________________________________
                                     Signature of Counselor

Number of years you have been a camp counselor: ___________________________
Print your name, mailing address, email address, and preferred phone number:


Name: _____________________________________________________________

Address (include zip code): ______________________________________________

__________________________________________________________________

Phone Number: _______________________________________________________

				
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