ST. SAVA SUMMER CAMP 2008

Libertyville, Illinois

SERBIAN ORTHODOX METROPOLITANATE OF MIDWESTERN AMERICA

in cooperation with

The Federation of Circles of Serbian Sisters of Midwestern America

APPLICATION FOR CAMP WORKER

Please type/print clearly. Applications are due on June 1, 2008. Return this application to:

Camp Director: Rev. Radovan Jakovljevic, 618 South Milwaukee Avenue Unit B,

Libertyville, IL 60048 Telephone: (847) 549-0798

NAME______

ADDRESS______

CITY ______STATE ______ZIP CODE ______

DATE OF BIRTH ______AGE ____HOME PHONE (_____)______

E-MAIL ADDRESS______SEX: M / F

YOUR PARISH NAME ______CITY/STATE ______

ARE YOU BAPTIZED OR CONVERTED IN THE EASTERN ORTHODOX FAITH? YES / NO

Have you worked at Libertyville Camp before? ______When? ______

In what capacity? ______

Do you suffer from an illness or have any disability that might restrict your activity? ______If yes, give descriptioN______

In case of emergency contact: ______Phone (____)______

Capability of service (check one or more): *

Nurse ______Housemother ______Kitchen Help ______

Indicate the week(s) you would be available:*

7/13/2008 - 7/19/20081st week (campers age 7 to 10)

7/20/2008 - 7/26/20082nd week (campers age 11 to 13)

7/27/2008 - 8/2/2008 teen week

T-Shirt Size: Adult’s S__M__L__XL___XXL___

*PLEASE UNDERSTAND THAT ST. SAVA CAMP CANNOT GUARANTEE THAT THE POSITION APPLIED FOR WILL BE AVAILABLE DUE TO THE HIGH VOLUME OF APPLICATIONS RECEIVED.

consent

In the event of an accident or medical need, I will be responsible for all medical or other expenses and will not hold St. Sava Camp, or the Serbian Orthodox Metropolitanate of Midwestern America or the Federation of Circles of Serbian Sisters responsible. I also agree to the terms and guidelines for Camp Worker at St. Sava Camp.

Signature of Applicant: ______Date ______

Signature of Parish Priest:______Date______

Parish Seal

Any behavior unbecoming camp staff will result in immediate dismissal. St. Sava Camp strictly prohibits alcoholic beverages, illegal drugs, fireworks or weapons of any kind. Any violation of these rules will result in immediate expulsion from camp!

St. Sava Camp provides room and board for all staff. If other arrangements are made off the camp grounds, St. Sava Camp, the Metropolitanate of Midwestern America and Federation of Circles of Serbian Sisters assume no responsibility for any expenses that may occur. Primarily for insurance purposes, no children, other than those participating in the camp program, are allowed to reside on the camp premises while camp is in session. Please make other arrangements for younger or older children during your week at camp. Thank you.

For Official Camp Administration Use Only:

Application Approved by:
Date: Applicant Notified (Date):______
Comments:______
______