Counselor Application

COUNSELOR APPLICATION
COUNSELOR Information
Full Name*

First NameLast Name
CELL Phone Number*

Area CodePhone Number
AGE*
HOME Phone Number*

Area CodePhone Number
E-mail*
Birth Date*

MonthDayYear
GRADE entering in fall:*
Gender*

MaleFemale
CHECK WEEKS AVAILABLE TO WORK:*

June 23July 7July 21
T-shirt Size*

Adult SmAdult MedAdult LgAdult XL

COUNSELOR APPLICATIONS MUST BE SUBMITTED BY JUNE 5!!

CAREFULLY READ, PRAYERFULLY CONSIDER EACH OF THE ITEMS LISTED BELOW.

BE SURE TO DISCUSS WITH PARENT OR PERSON RESPONSIBLE FOR GETTING YOU TO CAMP EACH DAY:
READ & CHECK TO ACCEPT EACH ITEM:*

MANDATORY TRAINING & SET-UP @ CFC-- June 20-- 9 a.m- 4 p.mMANDATORY CLEAN-UP @ CFC-- July 26 -- 9 a.m.- 2 p.m.I understand this is a commitment & will be ready to participate in ALL activitiesI will be @ camp every day @ 8 (or at hour designated 7 am Mon.) and stay until 3:30On Fridays I will be prepared to stay later for clean-upI need to come to camp EVERY day with a lunch, water bottle & backpackI must come to camp every day with closed toe walking shoesI understand all female counselors MUST wear a 1 piece (speedo style) swimsuit & shorts that are MIDWAY ON THE THIGHI understand I must come to camp with a facemask & wear during camp each day
Counselor Summary
The counselor will be a role model to campers by sharing their love for children and Jesus Christ.
The counselor must demonstrate maturity and personal concern for the safety and happiness of campers.
The counselor must assist, encourage, respect and cooperate with other counselors. Being a camp counselor is a voluntary position with a "gift" provided at the end of the week for your expenses.
I have read, prayerfully considered and fully understand the above information & requirements. I UNDERSTAND, IF ACCEPTED, THIS IS A JOB COMMITMENT AND NEED TO BE RESPONSIBLE IN FULFILLING MY OBLIGATION AS A CAMP COUNSELOR!
SIGN & DATE:*

Do you consider yourself to be a Christian? Why or why not:*
What makes you a good role model?*
What experience do you have in leading others?*
What skills or interests do you have that would make you a good camp counselor?*
Describe yourself in 5 words or less:*
How would you handle a camper that is being disruptive in your group?*
Are you CPR certified, or have any other special talents, skills or certifications?*
Please list a personal reference & phone number (NOT a family member)*
COUNSELOR COMMITMENT

I understand that this form is intended for use in evaluating my qualifications as a Camp Counselor. I authorize Bear Valley Kids Camp to verify any of this infomation. As can be expected, Bear Valley Kids Camp does not allow any of it's counselors to be involved with smoking, drinking alcoholic beverages, or using illegal substances. Inappropriate behavior may result in immediate dismissal.
SIGN & DATE:*

Parent/Guardian Information

(must be completed for ALL counselors & signed by parent for counselors under 18)
Name*

First NameLast Name
Address*

Street Address

Mailing Address

CityState / Province

Postal / Zip CodeCountry
Home Number*

Area CodePhone Number
Cell Number*

Area CodePhone Number
Counselor's Medical Needs or Restrictions:
Allergies to Food or Medication:
Current Medications:
Medical Release and Authorization

It is the policy of Bear Valley Kids Camp: in case of illness or injury, to make a reasonable attempt to promptly notify parents/guardians.

As Parent and/or Guardian of the named COUNSELOR, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of the minor child, in the event of a medical emergency.

Permission is also granted to Bear Valley Kids Camp and its affiliates including Directors, Counselors and volunteers to provide the needed emergency treatment prior to the child’s admission to the medical facility.

This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of life and limb of the named minor child, in my absence.
Informed Consent and Acknowledgement

I hereby give my approval for my child’s participation in any and all activities at camp. I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless Bear Valley Kids Camp & Summit Christian Fellowship and all its respective officers, agents, and representatives from any and all liability for injuries to registered camper arising out of traveling to, participating in, or returning from selected camp sessions.

I AGREE to grant to Bear Valley Kids Camp and its advertising and promotion agencies the right to use and publish worldwide and in perpetuity, in any and all forms of media now known or hereafter devised, including without limitation online and in social media, without approval or compensation, my image and/or performance captured at any Bear Valley Kids Camp activity or location.

In case of injury, I hereby waive all claims against Bear Valley Kids Camp & Summit Christian Fellowship. including all counselors and affiliates, all participants, sponsoring agencies, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all camp activities.

I acknowledge and fully understand the potential risk of COVID-19. While BVKC is making significant efforts to ensure the safety of campers, counselors, parents/guardians and or spectators, and volunteers, I acknowledge our camp events are not guaranteed to be COVID-19 free environments.

I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HERBY RELEASE AND HOLD HARMLESS Bear Valley Kids Camp and Summit Christian Fellowship, their officers, officials, agents, and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event (RELEASEES), WITH RESPECT TO ANY AND ALL ILLNESS, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF RELEASEES OR OTHERWISE, to the fullest extent permitted by law.
Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM 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.
COUNSELOR or Parent / Guardian Signature:*
Should be Empty:

COUNSELOR APPLICATION