Girls Can Camp Counselor Application
This is the application for volunteers who are volunteering for the 2019 Girls Can Camp session, held July 21-27, 2019 in Lee's Summit, MO.
First Name and Middle Initial
Your answer
Last Name
Your answer
Your Camp Name (ie. Hobbes, Froggy, Firefly, etc.)
Your answer
Mailing Address
Your answer
Cell Phone Number
Your answer
Phone Number (if different than cell number)
Your answer
Parent's Phone Number (if counselor is under 18 years old)
Your answer
E-mail Address
Your answer
Parent's E-mail Address (if counselor is under 18 years old)
Your answer
Birthday
MM
/
DD
/
YYYY
Occupation or Year in School
Your answer
How many years have you been to Rotary Youth Camp?
Your answer
What size of shirt would you like?
Mark all VALID certifications that apply. Please attach photocopies of cards or documents and submit them with this application.
Social Security Number
Your answer
Emergency Contact 1, Include name, relationship, and all phone numbers
Your answer
Emergency Contact 2 , Include name, relationship and all phone numbers
Your answer
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