Counselor Form - West Lafayette Christian Church

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Dear Counselors,
It is time once again for Summer Sonshine, and we are hoping you can join us as a counselor or
junior counselor this year. You probably already know that the week is filled with fun,
opportunities, LOTS of work, and exhaustion! As a counselor you will be an example of Christ
to the campers, as well as have opportunities to see your own faith grow from the experience.
Summer Sonshine 2015 will take place from July 13-17th. Attached you will find the counselor
form as well as more information about the week. Please read, complete, and return the
paperwork by June 12, 2015 (you may email it, mail it, or drop it off at church). If you have
friends that might be interested in serving, please have them contact me via phone or email
listed below.
There will be two pre-camp meetings you need to attend. The first meeting will be on June 28,
2015 at 4:00 pm. The second meeting will be on the Sunday afternoon before camp (July 12) at
a time to be announced later. Both meetings will be at WLCC.
We hope you can join us this year. I think you will be awed by serving God alongside many
other campers and counselors. Don’t miss the moment!
Blessings on your summer,
Drew Phillips
Contact info:
Drew Phillips
drew@wlchristian.com
317-432-0556
1980 Lindberg Rd.
West Lafayette, IN 47906
Wlchristian.com
COUNSELOR AND JR. COUNSELOR REQUIREMENTS:
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To love God, and be willing to serve Him and others
To enjoy the campers and show God’s love for them in your words and actions
Willingness to work hard, often at non-glamorous tasks (cleaning bathrooms for
example!) during camp week
Willingness to work as a team and treat your fellow counselors with courtesy and respect
Counselors are expected to dress appropriately, use appropriate language (no
derogatory or vulgar language or cursing), and maintain a positive attitude.
Counselors are expected to remain with their campers at all times unless directed to do
otherwise by an adult in charge. Interaction with the campers in all things (art, music,
rec, lesson, lunch) is expected.
While the counselors usually develop good friendships during the week, that is our
secondary focus. Thus, sitting with the kids during all above named activities, and
refraining from socializing with the other counselors while the campers are around is
expected. Pairing off or “being a couple” during camp is not allowed.
JOB DESCRIPTION
 Counselors are responsible for supervising the campers in their groups. The primary task
is to see that the campers experience the fun and learning the camp offers the entire
week. It is vital that the counselors: Make each camper feel welcomed and a part of
camp, demonstrate Christian principles in dress, speech and attitude, and
enthusiastically lead campers in activities. Counselors and Jr. Counselor hours will be 84 Monday and 8:30-4 the rest of the week. If you are also planning on working at another
job after camp, it is important that you set your schedule to allow you to stay at SS until 4
pm. A few exceptions can be made in extenuating circumstances, but these need to be
approved by me no later than the week before.
 Counselors will share the responsibility of maintaining the cleanliness of the church
building and grounds the week of camp. Counselors will be instrumental in the physical
needs of camp week i.e. lunch readiness and cleanup, recreation water and setup,
afternoon activities setup and breakdown etc…
 There is a small stipend for the week.
 There will be a mandatory training/prep session on Sunday, July 12th in the evening at
WLCC and one additional training session prior to that; on June 28, 2015 at 4:00 pm.
 Counselors and Jr. Counselors are asked to stay at camp on Friday afternoon in order to
set up for the evening program. It has become tradition that the counselors go to dinner
together before the evening program. More info will be available at the Sunday training
session.
 Counselors and Jr. Counselors who have younger siblings attending camp will need to
have transportation arrangements available. UNDER NO CIRCUMSTANCES should a
younger sibling be left at camp waiting on you to finish your job. We are not able to
supervise them during that 3-4 pm hour. While I know this is extremely inconvenient to
parents, it is vital. Parents are welcome to wait outside with your sibling until you are
through...most days the playground would be available for your siblings as long as a
parent is supervising. (If we finish our daily tasks before 4 pm, you will be dismissed
early. Please don’t count on it though.)
West Lafayette Christian Church
Summer Sonshine 2015 Day Camp
Counselor/Junior Counselor Application Form
As a counselor or junior counselor, some of your responsibilities will include: attending and participating in precamp meetings, arriving early each morning of camp to prepare for the day, interacting with the campers, being a
positive role model to the campers, having a positive attitude, and helping beyond what is expected to make the
camp great for everyone.
Name:
Address:
Phone:
Cell Phone:
Year in School (entering):
What School do you attend?
Text? Y or N
Date of Birth: _______________
__________________________
E-mail address:
T-shirt size:
Do you attend WLCC? ........................... ................................................ Yes ............. No
If not, what church do you attend? .........
Will you be available the entire week of camp (July 13-17)? Y or N, All Day AM only PM only
Have you ever attended Summer Sonshine as a camper?
How many years?
Indicate your preferences for the age group you’d like to work with by numbering from 1-3, with 1 being your top
choice, and 3 your last choice. Or check ANY if you have no preference. (No guarantees!)
__________K-2
____________3rd-4th
___________5th-7th
________ANY:)
What qualities do you possess that will make you a good counselor?
Why do you want to be a counselor?
What special gifts can you contribute to Summer Sonshine?
Is there anything extra you would like to help with this year?
Permission Photographic/Website Permission – I give permission to have my child appear in any media
coverage, by West Lafayette Christian Church website, bulletin boards, and videos for church purposes.
Applicant Signature
Please email this paperwork back to me by copying/pasting this form into a new email and entering your answers. Email to:
drew@wlchristian.com
If you receive a hard copy of this, return to me at: 1980 Lindberg Rd. West Lafayette, IN.
All counselors MUST have a permission slip/medical release form. If you or your parents have questions, don’t hesitate to
call. I can be reached at 317-432-0556.
WEST LAFAYETTE CHRISTIAN CHURCH
Medical and Liability Release Form
Student’s Name_______________________________Date of Birth ___/___/___Home Phone (____) _____-_____
Parent(s)/Guardians(s):___________________________________________Work/Cell Phone (____)_____-_____
___________________________________________Work/Cell Phone (____)_____-_____
Student’s Home Address________________________________________________________________________
City___________________________________________________State___________________ZIP____________
In case of emergency, notify:__________________________________________________Phone(____)____-____
Medical History and Information
Doctor’s Name_________________________________City_________________________Phone (____)____-____
Allergies
Insect Stings:_________________________________Drugs____________________Other___________________
Medical Conditions:
Heart Condition: ___No ___Yes___Restrictions______________________________________________________
Physical Handicap:___No___Yes___Restrictions _____________________________________________________
Chronic Asthma: ___No___Yes___Restrictions______________________________________________________
Epilepsy:
___No___Yes___Restrictions______________________________________________________
Hay Fever:
___No___Yes___Restrictions______________________________________________________
Diabetes:
___No___Yes___Restrictions______________________________________________________
Medications: ___No___Yes Name(s) and Dosage(s)___________________________________________________
Date
of
last
Tetanus
shot___/___/___
______________________________________________________
Activities
Can this student swim? ___No___Yes Restrictions:___________________________________________________
Any restrictions on other activities or sports? ___No___Yes Restrictions___________________________________
Insurance Information
Our church’s insurance is only secondary insurance. If you have medical insurance, your carrier will be billed for
medical charges in the case of illness or injury while your son or daughter is involved in a church-related activity,
Do you have health insurance ___No___Yes Provider
Name:_____________________________________________
Provider
Phone:_____________________________________________
Policy
Number:______________________________________________
(Please make a copy of your insurance card and attach to this form.)
Every youth ministry activity sponsored by this church is carefully planned and supervised by mature adults.
However, even with the best of planning and precaution, unforeseen events can occur. By signing this form, the
parent or guardian agrees to assume and accept all risks and hazards inherent in church-related activities. He or she
agrees not to hold West Lafayette Christian Church or its employees or volunteers liable for damages, losses, or
injuries to the person named above. He or she also understands that the signature below is for both a medical and
liability release.
In the event that I cannot be reached in an emergency, I hereby give my permission to the physician or dentist selected
by the West Lafayette Christian Church youth leaders to hospitalize, secure proper treatment, and/or order an
injection, anesthesia, or surgery for the person named above, as deemed necessary. I also agree to accept full
financial responsibility for the cost of such treatment.
Parent or guardian’s signature_____________________________________________________________ Date___/___/___
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