Camp Care Counselor Application - July 14-18, 2008 Please be careful when filling out the application - refreshing page or going back may cause you to lose information already filled in the application. Note: Counselors must be 16 years of age and available for entire camp session. Date: (mm/dd/yyyy) Name: Address:   City   Zip: Home Phone:   Cell Phone:   Work Phone: Sex: Male   Female             Age: Email: Emergency Contact:     Name:     Relationship:     Phone: Where do you attend school? If not in school, what is your level of education? Have you ever been a Camp Care counselor before? If so, list the years. Yes   No     Years: Have you ever been a counselor for a YMCA, BREC, school or another organization's camp? If so, please list the camp(s) along with years worked. Yes   No Other Camp Experience: List any courses that you hae taken that would relate to working with children. What do you think are the most important aspects to being a good counselor? What contributions do you think you can make to Camp Care and the children? What qualities/characteristics do you feel you possess which will make you an effective counselor? Please list some of your hobbies, fun things you like to do, accomplishments, etc. Shirt size: Small Medium Large Extra Large BY LAW, ALL VOLUNTEERS 18 YEARS OF AGE OR OLDER MUST AGREE TO UNDERGO A CRIMINAL BACKGROUND CHECK PRIOR TO WORKING WITH CHILDREN. I agree and understand the above statement: Yes   No      If applicant is UNDER 18 years of age, a parent or guardian must provide the statement below with accompanying signature, printed name, and date to Cancer Services of Greater Baton Rouge c/o Esther Sachse, 550 Lobdell Ave., Baton Rouge, LA 70806: (Name of Applicant) has my permission to attend Camp Care as a counselor, participate in all activities including swimming and field trips, and appear in photographs and on television for awareness purposes. In the event that I or the emergency contact cannot be reached, I give my permission for camp personnel to secure proper treatment for my child. I agree and understand that my guardian must write and send the above to Cancer Services: Yes   No      Please submit form no later than May 30, 2008. Early applicants will be placed first on the list of applicants for consideration of this enriching experience. Lend us your knowledge and talents. For more information, email Cindi Tramonte, or call (225) 927-2273.