Camp Counselor Application

Kent 4-H Horse Camp

June 26 and 27, 2017

All who apply will be notified of their selection. Counselors must attend a training session prior to the camp. More information will be provided to those selected.

Instructions: If you are interested in a position as camp counselor, please:

1.  Complete this application

2. Include with this application:

·  One letter of recommendation from an unrelated adult

3. Return all of these by June 3, 2017 to Lori Raimer

9676 Bluewater Highway Lowell Mi 49331 or

Email to:

Section 1

Name: 4-H Club:

First Last

Address: Age as of June 1, 2017:

Home phone: Cell:

Email:

Section 2 – Parent or Guardian Consent Form (required for youth under age 18 to participate)

If selected to serve as a counselor, I hereby grant permission for my child (print name) to participate in all educational and social activities at Kent 4-H Horse Camp 2017

Name of parent/guardian (please print)

Signature of parent/guardian Date

Section 3 – CODE OF CONDUCT AGREEMENT

I have read and agree to abide by the code of conduct included below.

Counselor applicant’s signature Date

I expect my child to abide by this code of conduct.

Signature of Parent/Legal Guardian for youth under age 18 Date

Please keep this page for your records – don’t turn in with application.

CODE OF CONDUCT

1. Positive behavior is a key expectation for youth participating in 4-H activities – behavior that reflects trustworthiness, respect, responsibility, fairness, caring and citizenship. Counselors are expected to fully participate, follow all event guidelines, and behave as a positive role model for the participants.

• Theft, vandalism, the use of illegal drugs, alcohol, leaving the camp boundaries and other such offenses are strictly prohibited. Anyone involved with these offenses will immediately be sent home and may be dismissed from the Kent County 4-H program. Those engaged in illegal activities will be turned over to the proper authorities. Repair costs for damages incurred to property will be billed to those responsible.

• Youth participants are not permitted to use tobacco in any form.

• Counselors may be dismissed for inappropriate behavior that violates the rights of others, particularly when the behavior is disrespectful regarding a person’s gender, race, age, religion, disability or appearance. You may not tease, hurt, or bully anyone, or use language, gestures or actions that will hurt others.

• Counselors should dress casually, but neatly and appropriately for the occasion. Shirt and closed toe

shoes/boots must be worn at all times.

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