2019 Ecojustice Camp Junior Counselor Application
Camp location: UUCPA, 505 E Charleston Rd., Palo Alto, Calif.
Dan Harper and Lorraine Kostka, Camp Directors; Mike Abraham, Business Manager
Camp Web site: www.ecojusticecamp.com
APPLICANT INFORMATION
Please fill out a separate registration form for each prospective Junior Counselor, thanks!
Name of Applicant *
Your answer
Grade as of May, 2019 *
Applicant birth date *
MM
/
DD
/
YYYY
Special information (allergies, etc.)
Your answer
APPLICANTS WHO HAVE NOT ATTENDED ECOJUSTICE CAMP
If the applicant has NOT attended Ecojustice Camp in the past, please answer the next 3 questions.
(Applicants who HAVE attended Ecojustice Camp before should skip ahead to "Parent/Guardian Information.")
What experience you have working with children?
Your answer
What outdoors experience do you have?
Your answer
Why do you want to be a Junior Counselor?
Your answer
PARENT/GUARDIAN INFORMATION
Please give contact information for all custodial parents.
Name of Parent/Guardian 1 *
Your answer
Mailing address of Parent/Guardian 1 *
Your answer
Email of Parent/Guardian 1 *
Your answer
Cell phone of Parent/Guardian 1
Your answer
Name of Parent/Guardian 2
Your answer
Mailing address of Parent/Guardian 2
Your answer
Email of Parent/Guardian 2
Your answer
Cell phone of Parent/Guardian 2
Your answer
Anything else you want us to know?
Your answer
ELECTRONIC SIGNATURE
By submitting this registration form, I commit my child to participating as a Junior Counselor in Ecojustice Camp.
1. I agree that I will complete a Media Release Form before my child begins their volunteer service as a Junior Counselor. 2. I agree that I will complete a Permission/Medical Release Form before my child begins their volunteer service as a Junior Counselor.
Signed (enter your name) *
Your answer
WHAT HAPPENS NEXT
(1) Teens who have previously attended Ecojustice Camp, and who apply before May 1, 2018, are automatically accepted as Junior Counselors.
(2) Teens who apply after May 1, or who have not attended camp before, will be accepted on a space-available basis — we recommend contacting the Camp Directors to check availability before filling out the application.
(3) All Junior Counselors MUST complete a 1 hour safety training before beginning their volunteer service.
(4) We plan to offer skills trainings and planning meetings before camp begins (these would count as community service hours). The Camp Director will notify all Junior Counselors of these opportunities.
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