County Camp Counselor Application
Print
out this form, complete the application and return to the County Extension
Office by:
MAHONING COUNTY
____________________________________________________________________________________
Name (First)
(Middle)
(Last)
____________________________________________________________________________________
Current Address (Street or Route, City, State, Zip)
Date of Birth __________ Age ______
4-H Club ___________________________________ Years in 4-H _______
(Month/Day/Year)
Phone Number ____________ School Attending
______________________________ Grade Level in School
_____
E-Mail Address _______________________________________________________________________
4-H CAMP EXPERIENCE:
Number of years as 4-H camper: ___________ Number of years
as 4-H counselor: ___________
List your responsibilities as camper: ______________________________________________________
_________________________________________________________________________________
List your responsibilities as counselor: ___________________________________________________
____________________________________________________________________________________
OTHER CAMP EXPERIENCE (Conservation, Leadership Camp, Scout Camps, School
Camps, etc.)
Camp Name
Describe Experience/Responsibilities/Year
Attended
___________________ ______________________________________________________
___________________ ______________________________________________________
___________________ ______________________________________________________
Why do you want to be a counselor for the 2005 4-H Junior Camp program?
(No more than 30 words)
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Rank the following camp program committees according to your interest and
willingness to give leadership to, if selected. Mark your top 3 choices.
___ Flag Ceremonies - Committee would be responsible for
working with assigned cabins to organize flag raising and lowering ceremonies,
(i.e. teach appropriate way to handle the flags, selection of songs and readings.)
___ Closing Ceremony/Candlelighting - Committee would be
responsible for organizing and conducting the final campfire ceremony as
well as the design and location of the candlelight display.
___ Campfire - Committee would be responsible for the layout
and lighting of evening campfires, and organizing the chief and ishkatays.
___ Tribal Meetings - Committee would be responsible for
organizing “get-to-know-you” activities, potential skit ideas, and meeting
outlines to assist the chiefs and sags of each tribe.
___ Vespers - Committee would be responsible for planning
evening reflection activities. (i.e. readings, songs, locations)
___ Recreation - Committee would be responsible for free
time activities and rainy day backup plans.
___ Evening Programs - Committee would be responsible for
organizing and conducting the evening activities. (i.e. movie on the lawn,
lip-sync and dance)
ADDITIONAL INFORMATION:
1. Do you know of any activities that will conflict with the counselor
training meetings, counselors camp, and/or 4-H Camp? Circle
YES or NO. If yes, what is (are) the conflict(s)?
_________________________________________________________________________________
____________________________________________________________________________________
2. List any activities/organizations in which you participate (i.e.
sports, band, Vo-Ag, yearbook, church choir):
____________________________________________________________________________________
____________________________________________________________________________________
3. List any special training or experiences (i.e., first aid, recreation,
babysitter's course, YMCA course, Red Cross course, lifesaving):
____________________________________________________________________________________
____________________________________________________________________________________
4. List any hobbies, interests, special skills, or talents (dancing,
music, drama):
____________________________________________________________________________________
____________________________________________________________________________________
5. Are you interested in working with the Cloverbud Day Camp Program?
Yes or No
COUNSELOR RESPONSIBILITIES:
As a 4-H Camp Counselor, I will be
expected to:
1. Attend the required counselor training meetings, including
an interview and Camp Whitewood’s counselor training,
established
at the first meeting.
2. Take an active role in the camp planning process.
I will offer suggestions, volunteer and follow through on my
responsibilities.
3. Conduct myself as an adult staff member -- that's what
I am!
4. Set a good example by not using profanity or telling
off-color jokes and stories.
5. Not have in my possession or use tobacco, alcohol, illegal
drugs, or fireworks while I am participating in the counselors
program and at 4-H Camp.
6. Be a responsible cabin counselor.
a. Help those assigned
to my cabin to find the cabin and get settled.
b. Get to know each
of the campers in my cabin personally and by name.
c. Have all campers,
including myself, check in any of their medications with the nurse.
d. Make sure that
all of my campers are familiar with Camp Whitewood and the camp rules.
e. Make sure each
camper uses good personal hygiene.
f. Help campers take
care of personal possessions.
g. Go over the camp
program of activities with my campers at least once a day.
h. Check for illness
or injury, but don't make a "fuss" about minor things.
i. Sleep on a bed
next to the door.
7. Be in my cabin with campers at all times between
the hours of "Lights Out" and "Rise and Shine".
8. Never punish a camper by ridicule or physical
punishment -- patience and understanding works wonders.
9. Urge safety at all times. Take time to explain
how and why to do something safely.
10. Be quiet when appropriate and help keep campers quiet.
11. See that all campers are involved in all activities.
Make sure no one is excluded.
12. Guide, suggest, and develop a feeling of planning and
doing things together at camp. All of this will in turn create a feeling
of freedom.
13. Make sure campers understand they are responsible for
their own behavior.
14. Be sure that all campers know that they must remain
on the camp grounds at all times.
15. Be on time to meals, classes, and activities.
16. Supervise table setting and dining room clean up when
assigned or necessary.
17. Conduct myself in a courteous and respectful manner,
exhibit good sportsmanship and be a positive role model for all
youth.
18. Respect, adhere to, and enforce the rules, policies,
and guidelines established by 4-H Camp Whitewood and the
Mahoning County 4-H program.
19. Be flexible -- plans do change -- and rains do come.
20. Feel free to discuss problems with any of the other
staff members.
21. Put campers ahead of my own enjoyment for the duration
of camp.
By signing below, I acknowledge that I have read and agree to abide by the
above responsibilities if selected as a camp counselor. I understand
and agree that I will be asked to call my parents/guardian immediately to
pick me up if I do not conduct myself in an adult manner.
________________________________________________
_______________________________________ Signature of Counselor
Date
________________________________________________ _______________________________________
Signature of Parent/Guardian
Date
Send completed application, program ideas and counselor
responsibility form to:
Ohio State University Extension - Mahoning County
490 S. Broad Street - Canfield, Ohio 44406
Back to 4-H Page