STAFF INFORMATION

Registration Options*

Counselor
Service
Safety

Name*

Email*

Phone Number*

Yes, it's okay to send me text messages including confirmations, changes, updates, and/or promotions. Message frequency varies. Message and data rates may apply. View our terms of service & privacy policy.

Address*

Gender*

Male
Female

Date of Birth*

HOW MANY YEARS OF CHURCH ATTENDANCE?

CHURCH ATTENDANCE FREQUENCY*

I ACKNOWLEDGE that Junior Counselors must be 22 years old, and Senior Counselors must be 25 years old*

PASTOR INFORMATION

PASTOR*

PASTOR'S FIRST/LAST NAME (if not mentioned above)

CHURCH NAME

CITY OF CHURCH

PASTOR OR CHURCH PHONE

PASTOR'S EMAIL

I AFFIRM THE ABOVE INFORMATION TO BE TRUE, AND AS THE STATED INDIVIDUAL WILL ABIDE BY ALL CAMP REQUIREMENTS UPON APROVAL AS STAFF OF CAMP WEST*

Signature*

By signing below you are agreeing to the Camp Guidelines, you acknowledge that both yourself (as the authorized registrant) and the participant (staff or camper), which maybe the same person, agree that the camper will follow the CAMP WEST guidelines specified in the Camp West Guidelines Document found on the website.

I, the undersigned, agree to the terms above.

TIME UNTIL EARLY REGISTRATION ENDS:

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TIME UNTIL CAMP WEST BEGINS:

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Email*

Name*

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