Summer Camp Volunteer – VFL Community Outreach CDC

Exchange Life Summer Camp Counselor Application 2025

The Danbury Lodge
14011 CR 602
Danbury, TX 77534

Name

Email *

Phone

Home Address

Apt, suite, etc.

Country

City

State

Zip code

Social Security Number

Driver's License No/State/Type

Date of Birth

Check the week(s) of camp in which you are interested in serving as a counselor

Senior June 24 – June 28 AGES 14-18

Intermediate June 24 – June 28 AGES 11-13

Junior June 24 – June 28 AGES 8-10

Required of all applicants:

Consumer Report/Disclosure Notification, Applicant Verification and Release, and Pastor’s Reference.

Please answer the following questions, using an additional page for the answers if you prefer.

1. What skills would you bring to the summer camp program?

2. What other camp/youth work experience do you have? (Please list)

Organization	Program	Dates	Contract

3. What do you want to serve at EL Summer Camp?

Church Activity

What church or churches have you attended in the past five years?

Church Name	Pastor’s Name	Years Attended

References (Other than relatives)

Name/Relationship	Address	Phone

BACKGROUND INFORMATION

Release of Information Form

I understand that a Background report may be obtained. I hereby authorize a criminal background (criminal history) search which includes a search of local, state and federal courts and/or law enforcement agencies and release all individuals, companies, corporations, and agencies, public or private, connected therewith from any and all liability associated with the dissemination of such information pertaining to me. I understand that I may request a complete and accurate disclosure of the nature and scope of the background verification, to the extent that such investigation includes information bearing on my character, general reputation, personal characteristics or mode of living.

Applicant's Printed Name

Date of Birth

Social Security Number

Driver's License No

State

Current Address

Apt, suite, etc.

Country

City

State

Zip code

Previous Addresses (for seven years)

Address

Apt, suite, etc.

Country

City

State

Zip code

Address

Apt, suite, etc.

Country

City

State

Zip code

Address

Apt, suite, etc.

Country

City

State

Zip code

Applicant's Signature

Reset Signature

Date Signed

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