Summer Blast & Camp Galena 2021 Counselor Application
Please fill out the application below to apply to be a counselor.

**APPLICATION DEADLINE: January 20, 2021**

SUMMER BLAST DATES (for campers grades 1-5): June 14-17, 2021
CAMP GALENA DATES (for campers grade 6-8 and CIT'S grade 9): July 10- 17, 2021

Any questions?? Contact Katie at
Email address *
Your Last Name *
Your First Name *
Counselor Name (if you have previously been a counselor)
Date of Birth *
Home Address *
City *
State *
Zip *
Your Cell Phone
Your School *
Year you will be entering in Fall 2021 *
How did you hear about camp? *
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