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Campus Day Camp Staff Application 2023
Campus Day Camp Staff Application
2901 Campus Rd. Brooklyn, N.Y. 11210 718.421.7575
Date
Full Name
*
Position
*
Date of Birth
*
Address
*
Address
Address
Address
City
City
State/Province
Alabama
Alaska
Arkansas
Arizona
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
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Washington
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State/Province
Zip/Postal
Zip/Postal
Phone
*
Email
*
Known Allergies / Medical Conditions
Emergency Contact
*
Relationship
*
Emergency Phone Number
*
Name
*
I
hereby authorize Campus ASP Inc. to take any emergency medical actions necessary.
Signature
*
Clear
Date
Briefly describe why you want to work in summer camp.
*
Describe why a camper would want YOU as his/her camp counselor this summer.
*
Please list any skills, interests or hobbies.
*
Do you have any other commitments (school, vacation, other job) between 6/29/23 - 8/11/23?
*
Yes
No
Will you be able to have a medical form completed by a physician before May 15, 2023?
*
Yes
No
Are you both mentally and physically fit to perform the duties required (Sports, swimming, strenuous exercise, bending, extreme temperatures, standing for long periods of time etc.)?
*
Yes
No
Attendance and punctuality are critical to a successful summer. Are you able to commit to the following: 6/29/23 - 8/11/23, 8:30am - 4:30pm?
*
Yes
No
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