Champions Kids Camp Camper Application

Champions Kids Camp 2024 Intern Application

Please Read ALL Application Instructions
An intern application is for a former camper who is now between the ages of 13 and 15 and wants to return to camp to become a leader in training. Must be filled out by the applicant with parent or guardian. 2 non-family references and a recent photo are required to be considered.

Please fill out each section of the application completely. If selected, we will email you all the necessary medical forms, maps, and clothing list prior to camp.

If you have any questions or concerns, please call Champions Kids Camp at 832-449-3743, email at info@championskidscamp.org, go to our website at www.championskidscamp.org, or write us at:

NEW Address:

Champions Kids Camp

9711 S. Mason Rd., Ste 125, Box 305

Richmond, TX 77407

Please notify us if your address, phone number, or e-mail changes. Without up-to-date information, you may miss the opportunity to attend Champions Kids Camp as an intern.

The signature of the applicant, and a parent or guardian must be on this application.

Important dates:

            Application due – May 31, 2024

              NEW DEADLINES

Completed medical forms (If accepted, we will mail forms (5) to you or send you a secure link via email) - June 20, 2024

            CAMP DATES – July 14 - 19, 2024

Carolina Creek Christian Camp

84 Wimberly Lane, Huntsville, TX (30 mins from Conroe)

Keep this information – You will need it later!!!

Intern Applicant Information
Intern Applicant Name*

First NameLast Name
Likes to be called
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Applicant Cell Phone (if applicable)

Area CodePhone Number
Parent or Guardian Name*

First NameLast Name
Parent or Guardian Phone*

Area CodePhone Number
Parent or Guardian Email*
example@example.com
Parent or Guardian Alt Phone

Area CodePhone Number
Date of Birth*

MonthDayYear
Date
Please select one*

MaleFemale
Age as of July 14, 2024*
T-Shirt Size*
Please keep in mind what size you might be at the time of camp in July
Please select year(s) attended as camper and/or intern*

2022202120202019201820172016
What is your reason for wanting to be an intern at Champions Kids Camp? *
What contributions do you think you can make to children at camp? *
Do you speak any foreign languages? Yes / No What language(s)? *
Please list any special skills, personal qualifications or hobbies that you feel would enhance experiences for the campers: *
Please describe your original reason for attending camp as a camper.*

Photo & References
A photo is required, so that we can easily identify you at camp (if accepted). You can upload a recent photo, or take a photo with your device. The form will not submit without one or the other completed.
Upload a recent photo

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or Take Photo
Attach two non-family references below.
Reference 1*

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Reference 2*

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Applicant Medical Information
Please list current medical diagnosis, behavioral/mental health diagnosis, behavioral concerns and known medication side effects. *
Type N/A if none
Please list all Current Medications (write N/A if none)*
Pharmacy Contact Number

Area CodePhone Number
Vitamins/Food Supplements (write N/A if none)*
Known Conditions, Allergies, & Previous Surgeries (write N/A if none)*
List any health concerns or limitations that might affect your ability participate in the general camp activities. If so, describe:*
Type N/A if none
Any dietary limitations MUST be manageable by the intern and not impede the ability to perform your duties.
Please list any school or legal discipline experiences. Explain:*
Type N/A if none

Alternate Contacts
Please list an alternate contact if the Parent or Guardian listed above is unavailable.
Alternate contact person*

First NameLast Name
Relationship To Child*
Phone*

Area CodePhone Number
Alt Phone

Area CodePhone Number
Therapist's Name (if applicable)

First NameLast Name
Work Phone

Area CodePhone Number
Cell Phone

Area CodePhone Number
Social Worker's Name (if applicable)

First NameLast Name
Work Phone

Area CodePhone Number
Cell Phone

Area CodePhone Number

Sign and Submit Application
I understand that making any false statement on this application will be sufficient for discharge. I hereby guarantee the correctness of the above statements. I hereby authorize you to contact my references. I understand that this is an application only and not a guarantee of a position.

*If accepted I pledge: I will listen to my Champs instructions and will follow all of the instructions, to work as a cohesive unit to serve all campers in our group. I understand that if I do not respect the Champ’s leadership or that of the staff I will be sent home immediately and will not be allowed to return.
Signature of Applicant*

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Signature of Parent or Guardian*

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Champions Kids Camp 2024 Intern Application