Counselor In Training Application

This application is appropriate for those entering 9th, 10th, or 11th grade in the fall

First name*

Last name*

Grade in the fall*

9th

10th

11th

Tshirt Size*

Location you wish to volunteer*

Moraga

San Ramon

Either

SEE SESSION DATES HERE

What sessions are you interested in? *

Session 1

Session 2

Session 3

Phone*

Email*

Multi-line address

Country/Region*

Address*

City*

Zip / Postal code*

Parent or Guardian (1)

First name*

Last name*

Parent Phone*

How many years have you attended ADC?

Please explain why you feel you would make a positive impact on the ADC program

Please list any specific skills or experience you have that may be useful to the ADC program

Please list any dietary restrictions, allergies, medications, disabilities or chronic recurring illnesses or special restrictions or considerations while at ADC

RETURNING CIT's ONLY: What was your greatest strength last summer? What improvements can you make to your overall performance?

For Parent or Guardian: I give permission for my child to participate in the Adventure Day Camp Program. I understand that child will be expected to follow the standards established for all volunteers. I understand that Adventure Day Camp cannot be responsible for any

injury that is not the fault of Adventure Day Camp, beyond assurance that the injury will receive appropriate professional care.

Parent Signature REQUIRED*

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I understand that I am acting in a voluntary, non-compensated capacity*

Agree