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Staff Application
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* Indicates required question
Last Name
*
Your answer
First Name
*
Your answer
Birthday
*
MM
/
DD
/
YYYY
Street Address
*
Your answer
City
*
Your answer
State
*
Your answer
Zip Code
*
Your answer
Phone Number
*
Your answer
Email Address
*
Your answer
Gender
*
Male
Female
Will you be attending the entire camp?
*
If not, please explain the reason and dates you will be available
Your answer
Please list the staff positions you are interested in (in order of most-preferred to not-most-preferred)
*
Your answer
T-Shirt Size
*
Choose
Small
Medium
Large
XLarge
XXLarge
Have you ever been staff before?
If so, which position and when?
Your answer
What is the name of the current school are you attending?
*
Your answer
What grade are you in?
*
Your answer
HEALTH
If not applicable (no allergies, medicine, or medical history), write N/A
Do you have any special dietary restrictions?
*
Yes, I am a vegetarian
Yes, I am a vegan
No
Other:
Allergies (include severity) and current medications
*
Your answer
Medical or illness history
*
Your answer
Emergency contact name
*
Your answer
Emergency contact relationship
*
Choose
Mother
Father
Sibling (over 18)
Friend
Relative
Other
Emergency contact phone number
*
Your answer
Medical Insurance
*
Your answer
Policy Number
*
Your answer
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