SUMMER CAMP Jr. Camp Counselor Application

Applicant Information Full Name: ______Age: _____ Phone: ______

Camp Hours are 7:30a – 4:00p; Monday through Friday

WEEK May 20 1 2 3 4 5 6 7 8 9 10 Camp T-Shirt Size: AVAILABLE HOURS M ______AVAILABLE Tu ______Please indicate on back if hours vary W ______from week to week of Th ______availability F ______

May 20th Theme: Schools Out for Summer! Week #1 June 1st – 5th Theme: Master Chefs – Jr. Week #2 June 8th – 12th Theme: We’re Running Away with the Circus

Week#3 June 15th – 19th Theme: Super Heros in Training Week #4 June 22nd – 26th Theme: Secret Spies & Pirate Adventures Week #5 June 29th – July 3rd Theme: Ninja Warriors Week #6 July 6th – 10th Theme: Road Trip Across America Week #7 July 13th – 17th Theme: Scuba & Jr. Lifeguard Camp Week #8 July 20th – 24th Theme: We’re Making a Difference (Leadership) Week #9 July 27th – 31st Theme: Future Olympians

School Attending: ______Grade ______Does Your School or a Program you belong to REQUIRE volunteers hours? YES NO How many hours are required? ______E-Mail Address: ______

Please tell us why you are interested in being a Jr. Counselor ______I, the parent or legal guardian of the Applicant, do authorize the submission for consideration for a Jr. Camp Counselor for the Active Kids Global/SWIMkids USA Summer Camp. ______Signature Printed Name Phone Number Date