Camp Kind Jr. Intern Application

*ONE FORM REQUIRED PER CAMPER.

Jr. Kind Counselor APPLICATION

Name*

First Last

Birthdate*

Pronouns

Grade (as of Fall 2023)*

Shirt Size*

Physician*

Physician Phone Number*

Relevant Medical Information (allergies, special needs, etc.):

What does kindness mean to you?*

What would you like to learn as a Jr. Kind Counselor?*

Name*

First Last

Preferred Phone Number*

Alternate Phone Number

Email*

Adults approved for pick-up*

Adults NOT permitted for pick-up

Name*

First Last

Phone*

Relationship to Camper*

Phone

This field is for validation purposes and should be left unchanged.