Camp Counselor & Assistant Counselor Application 2020
This application is for counselors and assistant counselors. If you wish to give your time and talents, please complete the application below.

There is a mandatory training/orientation for all counselors. The dates are Saturday 5/2 or Saturday 6/6


For questions regarding the application or volunteering at The Barn at Spring Brook Farm, please contact The Barn at 610-793-1037 or annie.kozicki@springbrook-farm.org
Email address *
RELEASE FORMS
In addition to completing this application, a release form must be mailed to:
The Barn at Spring Brook Farm
360 Locust Grove Rd
West Chester, PA 19382

The form can be found at: http://springbrook-farm.org/volunteer/
CLEARANCE REQUIREMENTS
All volunteers and counselors ages 18 and older are required to provide their criminal background check and child abuse clearances. Volunteers and counselors ages 14 - 17 are not required to submit clearances.
Please visit this checklist to complete your clearance and application requirements:
http://springbrook-farm.org/wp-content/uploads/2016/08/Counselor-Checklist.pdf
GENERAL INFORMATION
First Name *
Your answer
Last Name *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
How many weeks do you want to volunteer as a Camp Counselor? *
Camp Sign Up
For the following questions, please select the weeks you want to volunteer for Camp Geronimo 2020:
I am signing up for: *
I am signing up for:
I am signing up for:
I am signing up for:
I am signing up for:
I am signing up for:
T-Shirt Size *
Address (Street) *
Your answer
Address ( Apt #)
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Home Phone (xxx-xxx-xxxx)
Your answer
Mobile Phone (xxx-xxx-xxxx) *
Your answer
Work Phone (xxx-xxx-xxxx)
Your answer
Employer/Occupation
Your answer
May we contact you at work?
Are you 18 years of age or older?
PARENT AND GUARDIAN INFORMATION
IF APPLICANT IS UNDER THE AGE OF 18, PLEASE COMPLETE THIS SECTION.

IF YOU ARE 18 YEARS OF AGE OR OLDER, SKIP THIS SECTION AND MOVE TO THE "EMERGENCY CONTACT" SECTION.
Parent/Guardian Name
Your answer
Relation to Volunteer/Counselor/Intern
Your answer
Address (Street, City, State, Zip)
Your answer
Phone (xxx-xxx-xxxx)
Your answer
Parent/Guardian Name
Your answer
Relation to Volunteer/Counselor/Intern
Your answer
Address (Street, City, State, Zip)
Your answer
Phone (xxx-xxx-xxxx)
Your answer
EMERGENCY CONTACT INFORMATION
Please include 2 other people we may contact in an emergency.
Emergency Contact 1- Name *
Your answer
Phone (xxx-xxx-xxxx) *
Your answer
Address (Street, City, State, Zip)
Your answer
Relationship to volunteer/counselor/intern: *
Your answer
Emergency Contact 2- Name *
Your answer
Phone (xxx-xxx-xxxx) *
Your answer
Address (Street, City, State, Zip)
Your answer
Relationship to volunteer/counselor/intern: *
Your answer
TELL US MORE ABOUT YOU AND YOUR EXPERIENCE:
What is your major area of interest?
Your answer
Do you have experience with children with disabilities?
If yes, please explain:
Your answer
Do you have experience with horses?
Do you have experience with farm animals?
If yes, which farm animals do you have experience with?
Your answer
Please rate your horse/farm animal experience level?
Please describe any specific skills or volunteer interests you might have:
Your answer
How did you learn about The Barn at Spring Brook Farm?
Your answer
In order to participate in Camp Geronimo, counselor and assistant counselor training is required. Which date can you attend? *
Upon completion of this application, please sign up on Sign Up Genius for the weeks you would like to volunteer
If you are interested in volunteering as a camp counselor or assistant counselor, please visit the following links to sign up!
Week 1 (June 15 -19): https://www.signupgenius.com/go/9040F4AAFAB2DA0F85-camp
Week 2 (June 22 - 26):https://www.signupgenius.com/go/9040f4aafab2da0f85-week
Week 3 (June 29 - July 3): https://www.signupgenius.com/go/9040F4AAFAB2DA0F85-week1
Week 4 (July 27 - 31): https://www.signupgenius.com/go/9040F4AAFAB2DA0F85-week2
Week 5 (August 3 - 7): https://www.signupgenius.com/go/9040F4AAFAB2DA0F85-week3
Week 6 (August 10 - 14):https://www.signupgenius.com/go/9040F4AAFAB2DA0F85-week4

After signing up, please contact Annie at campgeronimo@springbrook-farm.org or annie.kozicki@springbrook-farm.org
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