May Youth Retreat Staff Application

Name*

First

Last

Birthdate*

Gender*

T-Shirt Size*

Main Area of Ministry*

Address*

Street Address City State / Province / Region Postal / Zip Code

Phone*

Alternate Phone

Email*

Home Congregation*

Name of Elder or Minister for Staff Reference*

Email of Elder or Minister for Staff Reference*

Do you have any children that will be attending camp this year (Camper or Pre-Camper)? If yes, how many?*

An application for campers must be completed separately from this Staff Application.

Name of Camper 1*

Birthdate of Camper 1*

Name of Camper 2*

Birthdate of Camper 2*

Name of Camper 3*

Birthdate of Camper 3*

Name of Camper 4*

Birthdate of Camper 4*

Driver's License Information

State*

Expiration Date*

License Number*

Do you have any previous convictions or investigations that would prevent you from working with or being around children?*

Please Explain*

From time to time we must get background checks on all camp staff. Do you give the directors permission to perform a background check?*

I have read the GUIDELINES FOR COUNSELORS posted above and agree to abide by them and I verify that all the information provided in this application is true and accurate to the best of my knowledge.*

The electronic signature below and its related fields are treated by Weeki Wachee Christian Camp like a physical handwritten signature on a paper form.

Electronic Signature*

Today's Date*

Payment

Campers and Staff - $40 each

Payment Method *

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Upon clicking Submit your application and payment will be processed and an email will be sent to the email address provided for your Staff Reference.