Camp Wheez 2023 Counselor Application

Camp Wheez 2023

Counselor Application

Camp Details

Dates: Monday, July 31 – Friday, August 4, 2023
Camp hours: 8:30am – 12:30pm
Location: First Presbyterian Church of Santa Barbara – 21 E Constance Ave, Santa Barbara, CA 93105
Counselors must bring their own lunch
COVID-19 vaccination is required for all counselors – completion of primary series and at least one booster (if eligible)

Applications (including Guardian Consent Form) are due by July 10, 2023.

Counselors must be available as follows:

Orientation: Tuesday, July 18, 3:00 – 4:30 pm
Camp: Monday, July 31 – Friday, August 4, 7:30 am – 1:00 pm (includes setup and breakdown time)

Contact Youngmi An, Camp Director with any questions or to confirm that your application was received - (805) 681-1793, campwheez@sansumclinic.org.

Name*

Date of birth*

Pronouns

Select or enter value

Other - Please specify

Address*

City*

Zip code*

Phone number*

Phone

Email*

What school do you attend?*

Grade in September*

Select

Dietary restrictions or food allergies

Experience

Have you attended Camp Wheez as a camper?*

Select or enter value

Have you volunteered at Camp Wheez as a counselor?*

Select or enter value

Do you have any experience working with children?*

Select or enter value

Please explain:

Do you have any experience with asthma?*

Select or enter value

Please explain:

Why are you interested in volunteering at Camp Wheez?*

List your talents and skills:*

Previous Work or Volunteer Experience*

Please list up to four (4) activities and the dates you participated. If none, enter "None".

Optional - Mark any interests. While we can’t guarantee roles, we will do our best to take your preferences into account.

Younger campers (ages 6 - 8)

Older Campers (Ages 9 – 12)

Cooking Lab

Games & Recreation

Arts & Crafts

Emergency Contacts - Provide at least 2

Contact #1 - Name*

Contact #1 - Relationship to you*

Contact #1 - Preferred phone*

Phone

Contact #1 - Alternate phone

Phone

Contact #2 - Name*

Contact #2 - Relationship to you*

Contact #2 - Preferred phone*

Phone

Contact #2 - Alternate phone

Phone

Contact #3 - Name

Contact #3 - Relationship to you

Contact #3 - Preferred phone

Phone

Contact #3 - Alternate phone

Phone

References - Provide 2

References are people who are are familiar with your work habits, preferably not relatives.

Reference #1 - Name*

Reference #1 - Relationship to you*

Reference #1 - Phone and/or email*

Reference #2 - Name*

Reference #2 - Relationship to you*

Reference #2 - Phone and/or email*

Parent/Guardian Authorization and Consent

To complete your application, we must receive an Authorization and Consent form from your parent or guardian. Click here to download the form.

Have your parent or guardian complete and sign the form within 1 week of submitting your application and send to:

Email: campwheez@sansumclinic.org

Mail: Sansum Clinic - Camp Wheez, PO BOX 1200, Santa Barbara, CA 93102-1200

COVID Vaccination

COVID-19 vaccination is required for everyone at Camp Wheez including campers, staff and volunteers.

COUNSELORS

Primary series of 2 shots – Required

Booster shot – Required

Please send a scan or photo of your vaccination card to campwheez@sansumclinic.org within 1 week of submitting your application.

If you are a returning counselor who volunteered in 2022, you do not need to submit your vaccination card.

Please check this box to confirm you have read and understand the COVID vaccination requirements.*

By entering my full name below, I attest that all of the information provided in this application is true and accurate.*

Send me a copy of my responses

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