Junior Counsellor Camp Application

**Please note: We ask that all Summer Camp Junior counsellors must be available for a minimum of 3 sessions of camp per season. Number of positions available will be dependent on camp sizes and registration.

Name(required)

Email(required)

Date of Birth (Year/Month/Day)(required)

Address(required)

Postal Code(required)

City(required)

Parent/Guardian 1 (required)

Parent/Guardian 2

Email 1(required)

Email 2

Phone 1(required)

Phone 2

Emergency Contact (Name)(required)

Emergency Contact (Phone #)(required)

Have you ever suffered from asthma, heart problems, breathing problems or any other medical condition that may affect your ability to participate in this program?(required)

Are you on any medication that we need to know about?(required)

Do you have any allergies? Please specify.(required)

Do you have any alternative accommodations needed to perform in this role? Please specify.(required)

Have you spent at least 1 summer in the LIT program?(required)

Yes No

Why do you want to become a Junior Counsellor?(required)

What are some qualities you have that would be helpful in this position?(required)

What is something that you learned while participating in the LIT program that could help you as a Junior Counsellor?(required)

Explain a situation where you had to be a leader.(required)

Explain how you would describe a game of your choice to a group of campers who have never played it before.(required)

Please check all the sessions you are available:(required)

July 3-14: Disney Around the World July 17-28: Everyday Heroes July 31-Aug 4: Under the Big Top August 8-11: Wheel of Themes August 14-18: Enchanted

Injury Waiver: Each student and his or her legal guardian(s) hereby release Milton Youth Theatre Productions and Directors, Teachers and Employees from claim for personal injury sustained in, on or about the facilities.(required)

Photography & Video Waiver: Each student and his or her legal guardian(s) hereby release Milton Youth Theatre Productions the rights to all photography and video that may be taken by or for Milton Youth Theatre Productions during classes or performances, for use in advertising and promotion, including television coverage.(required)