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2023Tri-County Camp Leaders
CABIN AND JUNIOR CABIN LEADERS: THIS FORM IS TO BE COMPLETED BY CHURCH CAMP COORDINATORÂ
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* Indicates required question
Church attending Camp with
*
Your answer
Last Name
*
Your answer
First Name
*
Your answer
Applicant's Email Address:
*
Your answer
Mailing Address (street, city, zip code)
*
Your answer
Cell Phone
*
Your answer
Home phone
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Gender
*
Male
Female
How would you like to serve at Camp?
*
Spark Cabin Leader (Grades 3-6)
Spark Junior Cabin Leader (Must be at least 17 years old or have completed Grade 11)
Ignite Cabin Leader (Grades 7-10)
Kitchen Help
Set-up/Break-down (during camp)
Other
Required
If you marked "other" in the previous section, how would you like to serve in camp?
Your answer
T shirt size
*
Adult:Small
Adult:Medium
Adult:Large
Adult:X Large
Adult:XX Large
Adult:XXX Large
Adult: XXXX Large
Medical Conditions
*
Are you currently under a doctor's care?
Yes
No
If so, for what?
Your answer
Doctor's Name, City and State:
Your answer
Do you have health insurance?
*
Yes
No
Name of Insurance Company
*
Your answer
Will you be taking medication at the time of camp?
*
List all medications
Yes
No
Other:
If yes, please list all medications
Your answer
Allergies to food or medication?
*
Please list all known allergies (if none, type "None")
Your answer
Do you have any physical disabilities that would keep you from active sports participation?
*
If yes, please list them; if none, type "None":
Your answer
Emergency Contact
*
Please give
name, relationship, and phone number
of individual(s) to contact in the event of an emergency.
Your answer
We consider ALL Camp Leader and volunteer positions at camp to be a ministry because each leader has an impact on the children and teens at camp in some way. Why do you want to serve at TCBA's Summer Camp?
*
Your answer
Give a brief account of your Christian experience (i.e., why you accepted Christ as your Savior, what that means to you, how you live and follow Christ, etc.):
*
Your answer
Applicant agreed to consent statement
*
Yes
No
Applicant's pastor recommendation
*
Yes
No
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