Staff Application
Last Name *
Your answer
First Name *
Your answer
Birthday *
MM
/
DD
/
YYYY
Street Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Phone Number *
Your answer
Email Address *
Your answer
Gender *
Will you be attending the entire camp? *
If not, please explain the reason and dates you will be available
Your answer
Please list the staff positions you are interested in (in order of most-preferred to not-most-preferred) *
Your answer
T-Shirt Size *
Have you ever been staff before?
If so, which position and when?
Your answer
What is the name of the current school are you attending? *
Your answer
What grade are you in? *
Your answer
HEALTH
If not applicable (no allergies, medicine, or medical history), write N/A
Do you have any special dietary restrictions? *
Allergies (include severity) and current medications *
Your answer
Medical or illness history *
Your answer
Emergency contact name *
Your answer
Emergency contact relationship *
Emergency contact phone number *
Your answer
Medical Insurance *
Your answer
Policy Number *
Your answer
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