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Counselor Application Request
Camp Rock 2019
By completing this online form you are requesting an application to be
considered as a Camp Rock counselor. You will be sent via US mail the
application form, Parental Consent form, the Medication form and the Code of Conduct form. All forms must be received by Wednesday January 2, 2019 for you to be considered.
First Name *
Your answer
Last Name *
Your answer
Address *
Your answer
City *
Your answer
Zip Code *
Your answer
Gender *
Cell Phone # *
Your answer
Email Address *
Your answer
School *
Your answer
Grade *
Parish *
Your answer
Birth Date *
Tee Shirt Size *
Have you ever been a counselor at Camp WOW or Camp Rock? *
Have you ever been a camper at Camp WOW or Camp Rock? *
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