JC Application Form

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					                            Junior Counsellor Application Form
                      Thunder Bay United Churches Children’s Camp 2012
                                 Due Date: May 10, 2012
 Drop off or mail to: First-Wesley United Church, 130 Brodie St. N., Thunder Bay, ON P7C 3S3
          Camp Organizer: Rev. Ken Moffatt, 346-8964, email: kmoffatt@tbaytel.net

Age Requirement: 14 years and up

Please fill out the questions below. If you require additional space for your answers, please feel
free to attach an additional sheet. Please also return a Volunteer Criminal Records check from
Thunder Bay Police; the cost for this will be reimursed to you as a volunteer.

Why are you interested in being a Junior Counsellor?

Please list a previous leadership experience.

List several interests or extra-curricular activities in which you may be involved.

How do you intend to take initiative with your tasks at camp? (i.e. Going above and beyond
your duties)

What course of action would you take if you encounter a camper who does not want to
participate in an activity?
Please list 3 references for us to contact; references may not include immediate family




Note: All applicants will be interviewed on Saturday, May 12, 1:30 – 4:00 p.m. For applicants
from out of town, a telephone interview may be possible.
                      Thunder Bay United Churches Children’s Camp 2012
                                        Code of Conduct
All campers and staff are to adhere to the Code of Conduct, as set by the Directors and
members of the Administrative Board of Camp Duncan;

       All basic rules of the camp, as set by the directors, are to be followed throughout the
        duration of the week, including, but not limited to:
        o Participating in cabin duties, and camp activities
        o Following direction of counsellors
        o Adhering to safety regulations, etc.

       We expect all campers and staff to practice healthy hygiene practices throughout the
        week. We will be providing hand sanitizer and soaps in the washrooms, and encourage
        campers to bathe and wash their hair in the lake every day (please send only
        biodegradable shampoos for this purpose). We want to make sure everyone is happy,
        healthy and clean!

       There is to be no consumption of drugs, alcohol or anything deemed to be potentially
        toxic or jeopardizing to campers physically or to the morale of the camp.

       There is to be no vandalism or damage to camp properties, including cabin walls, bunks
        and tables. This is non-negotiable, and infraction may result in dismissal of camper
        from the camp for the remainder of the week.

        bullying or harassment of any kind will result in immediate investigation by staff, and
        may result in immediate removal of campers involved. This includes any acts or verbal
        interactions that jeopardize the safety or mental health of another camper(s), such as
        profanity, insults or mean-spirited jokes. This is a non-negotiable rule.

I have read and reviewed the rules and regulations of the Code of Thunder Bay United Churches
Children’s Camp with the above camper, and the camper has an understanding of the rules and
regulations. As a parent/legal guardian I understand that failure to comply with these
regulations may result in the removal of the camper from the property for the remainder of the
week, without refund of camp fees.

______________________________               _______________________________
(Parent/Guardian Signature)                        (Date)

(This form to be returned with Camper Registration.)

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