2024 Glenn County 4-H Camp - Teen Camp Counselor and Youth Director Application

First Name  ✻

Last Name ✻

Phone Number ✻

Cell Phone Number ✻

Email (can't be a school account) ✻

Mailing Address ✻

City ✻

State ✻

Zip Code ✻

County ✻

Gender ✻

Are you currently enrolled in 4-H? ✻

Age as of December 31, 2023 ✻

Grade entering in August 2024 ✻

In case of an emergency, please contact (Insert Name): ✻

Relationship ✻

Phone Number

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T-Shirt Size for Camp ✻

Have you attended Glenn County 4-H Camp as a camper in previous years? ✻

If you answered yes, how many years have you previously attended as a camper?

Have you attended Glenn County 4-H Camp as a Teen Camp Counselor in previous years? ✻

Tell us about your previous experiences working with children (i.e., babysitting, church, Jr. Leader, Kiwanis, other). What did you like and dislike about working with the kids? ✻

What experience do you have as a leader? What leadership roles have you held in the past (include both inside 4-H and outside 4-H Leadership roles)? ✻

What skills do you want to learn/grow from your role and experience as a 4-H Teen Camp Counselor or Youth Director? ✻

What do you want the campers to learn from their experience as a camper? ✻

Are there any concerns you may have or have something that would be good for us to be aware of? ✻

What do you believe 4-H Camp's goals, should be? ✻

Reference 1 First Name, Last Name ✻

Reference 1 Phone Number ✻

Reference 1 Relationship

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Reference 2 First Name, Last Name

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Reference 2 Phone Number

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Reference 2 Relationship

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Reference 3 First Name, Last Name

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Reference 3 Phone Number

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Reference 3 Relationship

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Will you be able to stay, for the duration of camp (Wednesday, June 19- Sunday, June 23, 2024)? ✻

Teen Camp Counselor and Youth Director commitment statement: If chosen as a Teen Camp Councelor or Youth Director, I will commit to understanding the requirements and responsibilities of being a good Teen Camp Counselor or Youth Director. I will commit to completing all the training and being at 4-H Camp each day for my duties as assigned. I understand that being aTeen Camp Counselor or Youth Director is a huge responsibility and I will be attending camp not as a role model for campers. I am willing and able to give of myself to help them grow and develop and enjoy 4-H camp. I submit that all information on this application is true and complete. I have read and understand the role and description of a Youth Director and will abide by the practices set forth by the Glenn County 4-H Camp Committee. I understand that if I do not meet the standards of a responsible Teen Camp Counselor or Youth Director, I will be dismissed from my duties. This role and description are not intended to be all-inclusive.

By placing my initials in the box provided, I'm committed to participating in the 4-H Camp planning process and I will attend 4 of the 6 scheduled planning meetings. If I can't make a meeting or need to make arrangements, I will notify our 4-H Camp Director, Maddie Coleman, and make arrangements. I understand that there may be a planning meeting on a weekend, and our Camp Director will work with us to find a time that works best.

If you agree to the terms listed above, please place your initials in the space provided.  ✻

By placings my intials in the box provided, I agree to upload or turn in the Health History Form, Glenn County 4-H Camp Teen Counselor Camp Rules 2024, and one Letter of Recommendation by the Camp Application deadline of Friday March 22, 2024. To turn these forms in electronically, the "upload" option is located at the bottom of the survey. The link to the Health History and Authorization form and Camp Rules 2024 is accessible at the bottom of the survey. This form can be dropped off at the UCCE Office located at 821 E. South St., Orland, or can be emailed to glenncounty4h@ucanr.edu, by the deadline.   ✻

As the parent/guardian of the youth completing this application, I understand the necessity to only select individuals who are committed to the 4-H camping program. I will, to the best of my ability, support and encourage my teens to uphold their commitment to the Glenn County 4-H Camp Committee. I understand that if my teen does not meet the standards of a responsible Youth Director, they will be dismissed from their duties. If you agree to the terms listed above, please place your initials in the space provided.  ✻

Name (First name and last name) ✻

Phone Number ✻

Name (First name and last name)

 Phone Number

Name (First name and last name)

Phone Number

Are there any special accommodations needed?  ✻

Please indicate why you want to hold the position as a Youth Director at Camp this year. Describe what skills and abilities a Youth Director Should obtain.

Teen Camp Counselor and Youth Director Registration Fee (Teen Counselor and Youth Director Fee is $50.00. There is a $2.00 service fee added per person when paying by credit card.) You will need to complete a new survey for each person you are signing up. ✻