Adult SEEK Returning Counselor/Staff Application

Returning Counselor/Staff Application

Adult SEEK Camp -- June 8-11, 2023
Counselor/Staff Name

First NameLast Name
Birth Date*

MonthDayYear
Gender*
If you are 18 or older on June 1, 2023, you must submit a background check. After your registration is confirmed, we will send you a link for thebackground check.
Parent/Gaurdian Email address (if under 18)
Counselor/Staff E-mail*
Counselor/Staff Mobile Number*

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Number of years served at Adult SEEK
Number of years served at another SEEK Camp
T-Shirt Size*
Church Affiliation/Membership (if applicable)
Church Staff Contact Name
Church Contact E-mail
Permission to use photos on website/Facebook?*

YesNo
Should be Empty: