Counselors / CIT Application

Counselor Information

Name*

Email*

Cell Phone

Home Phone

Address*

Date of Birth

Parent Name*

Parent Email*

Parent Phone*

Other Information

T-Shirt Size*

Grade in Fall 2022

School Name

I have been involved with Sebago before as a:

Counselor
CIT
Camper
No Previous Involvement

Availability:*

I am available for staff training June 17-19
I am available to serve at the camp from June 19-25

Writing Submission*

Please write a 500 word job description of what makes a great Sebago Leadership Camp Senior or Junior Counselor, OR Attach a File Below (Word or PDF)

File Upload (optional)

Accepted file types: doc, docx, pdf, Max. file size: 2 MB.

Electronic Devices Policy

Preferably, electronic devices (smartphones, iPads, and the like) will be left at home. The reason for leaving these types of devices at home is to foster a tone of camaraderie and friendship. Unfortunately, at times, electronic devices have the opposite effect—tending to isolate people and be an obstacle to conversation. *If you do bring one of these devices, the staff will collect them upon arrival. There will be a couple of times during the camp that you will have access to them so you may respond to important messages or calls. (Coverage, however, may be quite limited.) Parents may reach participants at any time by calling Raymond Le Grand at 972-904-1002 or JP Lechner at 202-733-0771.

Medical / Insurance Information

Pertinent Health Information, including allergies, medications, etc.*

Insurance Company*

Insurance Company Phone #*

Policy Number*

Insurance Group Number (if applicable)

Waivers

Participation and Liability Waiver*

I hereby give permission for our son to participate in all activities conducted by SLC. We agree to hold the directors and staff harmless from any liability to anyone on account of any injuries to our son. I understand that SLC cannot be responsible for lost or broken items.I understand my son will comply with all cabin policies and procedures. I also understand, and will comply with, all cancellation policies and procedures.

Photo Release*

I hereby authorize and consent to the use and reproduction by SLC staff or an authorized agent or assignee of any and all photographs taken of my son for the purpose of promoting SLC without any compensation to me. All film, together with any prints, shall constitute property of SLC, solely and completely.

Medical Waiver*

I hereby delegate authority to the Directors of the Sebago Leadership Camp (SLC) to arrange whatever medical treatment they deem necessary for him during his stay at the camp. By typing my name below, I certify that I am the parent or legal guardian of the applicant listed.

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Counselor Application

Counselor Information

Other Information

Electronic Devices Policy

Medical / Insurance Information

Waivers

Camp Address