Name *
Please include maiden name and any alias names you may go by.
Date of Birth *
Date of Birth
If Junior Staff
Address *
Phone *
For Staff Shirts
Please list the name and age of each child eligible for Daycare Program. Camp Ao-Wa-Kiya’s Daycare Program is limited to children who are 4-10 years of age. We ask that you make other arrangements for children who will not be campers or be eligible to serve as Junior Staff.
Camp Weeks *
Please check the week(s) for which you are applying to serve.
Staff Positions
Please check the position(s) in which you would be willing to serve.
Food Service Positions
Please check the position(s) in which you would be willing to serve.
Please mark the following that you have current certifications in:
Please mark your ability level on each of the following areas
1=Very Experienced/Could Teach; 2=Some Experience; 3=No Experience
Reference 1
Reference 1 Name *
Reference 1 Name
Reference 1 Phone
Reference 1 Phone
Reference 2
Reference 2 Name *
Reference 2 Name
Reference 2 Phone
Reference 2 Phone
Reference 3
Reference 3 Name *
Reference 3 Name
Reference 3 Phone
Reference 3 Phone
Realizing the great responsibility and opportunity of working with children at Camp Ao-Wa-Kiya, I agree to: Sacrifice personal desires in the interest of the campers; Cooperate with the directory and other leaders under whom I serve; Obey camp and staff regulations printed in the staff manual; Endeavor to be a blessing to the campers with whom I work by helping to enrich their lives spiritually, physically, and mentally; and Uphold the standards and doctrinal position of Camp Ao-Wa-kiya (a copy of the doctrinal statement may be obtained at I hereby release and agree to hold harmless from liability any person or organization, whether listed or not, who provides information or references about me to Camp Ao-Wa-Kiya. I waive any right I might have to inspect references provided on my behalf. I certify that I have neither been convicted of, nor am I the subject of pending charges, for any offence involving actual or attempted child abuse or sexual molestation in any jurisdiction. If you agree, write your full name below.

You can also download an application to print out here, and then mail it to the camp address.