2024 Summer Start Application

if you have any questions about the summer start program, please contact US AT MAIL@ao-wa-kiya.org

Section 1

Personal Information

Name

First Name

Last Name

Are you a Returning Summer Start Participant?

Date of Birth

YYYY

Age

School Grade Entering

Gender

Are You a US Citizen?

T-Shirt Size

Section 2

Contact Information

Address

(If Different)

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Best Phone Number to Contact You

Phone

(###)

###

####

Section 3

Preferences / Skills

Have You Been on Staff Previously?

If Yes, in What Way?

Please mark each of these Support Positions in your order of preference, 1 being the highest

Health Services Preference

Programming Preference

Lifeguard Preference

Media (Incl. Photography) Preference

Food Service Preference

Maintenance Preference

Groundskeeping Preference

Daycare Preference

Tech Team Preference

Check all that Apply:

Certifications

Please mark the following that you have current certifications in:

Lifeguard

Lifeguard Trainer

CPR/AED

First Aid

CDL

PLEASE MARK YOUR ABILITY LEVEL ON EACH OF THE FOLLOWING AREAS

1=Very Experienced/Could Teach; 2=Some Experience; 3=No Experience

Challenge Course Ability

Rock Climbing Ability

Paintball Ability

Outdoor Life Ability

Horsemanship Ability

Worship Ability

.22 Riflery Ability

Air Riflery Ability

Archery Ability

Woodcraft Ability

Handcrafts Ability

Photography/Video Ability

Sailing Ability

Canoeing Ability

Fishing Ability

Swimming/Water Obstacle Course Ability

Wakeboarding Ability

Kayaking Ability

Section 4

References

Reference 1 (Spiritual Mentor)

Must be non-relative

Reference 1 Name

First Name

Last Name

Reference 1 Relationship

Reference 1 Email

Reference 1 Phone

Years Known Reference 1

Reference 2

Must be non-relative

Reference 2 Name

First Name

Last Name

Reference 2 Relationship

Reference 2 Email

Reference 2 Phone

Years Known Reference 2

Reference 3

Must be non-relative

Reference 3 Name

First Name

Last Name

Reference 3 Relationship

Reference 3 Email

Reference 3 Phone

Years Known Reference 3

Section 5

Spiritual Maturity

How have you grown spiritually in the last year?

Church Affiliation

Your salvation experience

Your prayer and devotional life

Final Section

Wrap-up Questions

Have you been convicted of a crime?

(other than minor traffic violations)

If yes, please explain:

Do you have any physical limitations?

Do you have any communicable disease?

If yes, please explain:

Additional Comments

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 ao-wa-kiya.org). 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.

Staff Agreement

I Agree to the statement above