2019 TheEdgeCamp Student Leadership
*** To be completed by the student who is interested in serving as a student leader at EdgeCamp.
*** Please call or email Ms. Julie for an interview.
Email address *
First Name: *
Your answer
Last Name: *
Your answer
Contact Number: (Student cell number please) *
Your answer
Home Address: *
Your answer
Birth date: *
MM
/
DD
/
YYYY
Gender: *
Highest grade completed *
Your answer
School: *
Your answer
GPA: (Most recent) *
Your answer
Previous work experience: (most recent listed first) *
Your answer
Why are you interested in TheEdgeCamp Student Leader Position? *
Your answer
What is your experience working with school age children? *
Your answer
Other experience applicable to working at summer camp? *
Your answer
Special Interests (leisure, academic, career...) *
Your answer
Available weeks attending Camp: (M-F, 9am-4pm) *
Required
Available day(s) of the week attending Camp: *
Required
Available time attending Camp: *
Your answer
Want camp lunch? (Provided) *
T-shirt Size: (Provided) *
Name(s) of Parent/Guardian living with student: *
Your answer
Emergency Contact Name & Number: *
Your answer
Family Doctor Number: *
Your answer
Health Plan: *
Your answer
Policy Number: *
Your answer
Health History: *
Required
Please give details on any health issues checked above: *
Your answer
Any activity restrictions: *
If yes, give details *
Your answer
To be completed by Parents/guardians:
Authorization to Consent for Emergency Treatment of Minor *
Required
Waiver of Rights and Release of Liability *
Required
Photo Release *
Field Trip Authorization *
I hereby authorize my child to leave Zion campus during lunchtime.
I hereby authorize my child to depart Zion campus after work.
I acknowledge that the above information is accurate to the best of my ability. *
Required
A copy of your responses will be emailed to the address you provided.
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