PERSONAL INFORMATION
First Name
Last Name
Gender
*
Male
Female
Social Security Number
*
Date of Birth
*
MM
DD
YYYY
Current Age
*
Cell Phone
(###)
###
####
Email
*
Mailing Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Do you have any physical limitations that would limit you from normal camp activities? If YES, please describe.
T-shirt Size
*
Adult Small
Adult Medium
Adult Large
Adult X-Large
Adult 2X
Do you currently hold a Red Cross CPR or Water Safety Certification?
Yes
No
List your talents and areas of interest (ie sports, singing, crafts, …)
Pastor
How often do you attend?
In what areas do you serve and how often?
Tell us about where, when and how you came to know Jesus as your Savior.
What are you currently doing to grow in your walk with the Lord?
How would you explain the Gospel to a camper? Please include the Bible references you would use.
Are willing to be transparent with your social media accounts? If yes, please list all accounts and usernames. If no, please explain why.
*
REFERENCES
Pastoral Reference (name, church, phone number)
Personal Reference (no relatives)
Have you ever been accused of molestations, exploitations or abuse?
*
Yes
No
Why do you want to be a Camp Open Arms counselor?
How did you hear about Camp Open Arms?
Background Check
*
Signature
