Applicant Name

First Name

Last Name

Age

Current School

Grade

Allergies (if applicable)

Hobbies

Camp is from June 19th-Sept 1st (M-F), could you please list days/weeks the above applicant can attend Easel's Summer Camp as a Junior Counselor for a 8:30am-1:30pm shift

Parent/Guardian Name

First Name

Last Name

Address

Preferred Phone

Please indicate which phone you are best reached at during the day

Home Phone

(###)

###

####

Cell Phone

(###)

###

####

Work Phone

(###)

###

####

Please list all persons, besides parents, approved to pick up or drop-off the applicant with phone numbers. (If a person who is not on this list will be picking up your child, please leave us a phone message/email/note with your approval).

Please add any additional info regarding your child's schedule here:

Jr Counselor Application

JUNIOR COUNSELOR APPLICATION FORM