Health Form
-Fill our this form at least four weeks prior to your arrival. People hired within four weeks of their start date should not send this form; bring it with you and give it to the Health Center staff at camp.
-Notify the camp director if you are exposed to a communicable disease within three weeks of beginning your job.
-The camp expects that you arrive in good health and capable of performing the essential functions of your position. If you have concerns regarding this, speak with the camp director prior to arrival.
-Information on this form is available to Health Center staff and your work supervisor(s) as necessary.
-Completing some portions of this form is voluntary; such areas are so marked.
Email address *
First Name *
Your answer
Middle Name *
Your answer
Last Name *
Your answer
Sex *
Birthdate *
MM
/
DD
/
YYYY
Permanent Address
Your answer
Permanent Address City
Your answer
Permanent Address State
Your answer
Permanent Address Zip Code
Your answer
E-Mail
Your answer
International Staff : Rate your ability to read and speak English.
Low Ability
Fluent in English
Is this your first year as a staff member? *
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