Camp Summertime/Camp Turtle Rock

Camper Assistant Leader Internship Application

818-706-7335 / 805-375-2267 ~ P.O. Box 420, Agoura, CA 91376

mark@campsummertime.com

First Name	*
Middle Name
Last Name
Camper Position Applying For Assistant Leader Internship Program (campers entering 10th, 11th or 12th grade next Fall)
Current Address
Street
City
State
Zip Code
Home Phone
Cell phone
Email Address
Dates of availability
Age groups you would like to be grouped with		4 - 5 yrs 6 -8 yrs 9 -11 yrs 12-14 yrs
Education History
High School Name and dates attended
Other Certifications completed
Why do you want to be a part of our camper assistant leader internship program?
Why did you choose our camp to apply and attend?
What was your favorite teacher or role model and why?
List anyone that you know that has attended or worked for Camp Summertime or Camp Turtle Rock
Activity Experience: Put a 1(have played a little bit), 2(have an average amount of experience) or 3(have a lot of experience and can lead activity)
Swimming		1 2 3
Soccer		1 2 3
Archery		1 2 3
Boating		1 2 3
Fishing		1 2 3
Rock Wall / Climbing		1 2 3
Music		1 2 3
Arts and Crafts		1 2 3
Ceramics		1 2 3
Leather		1 2 3
Song Leading		1 2 3
Volleyball		1 2 3
Marine Science		1 2 3
Video/Photography		1 2 3
Martial Arts		1 2 3
Basketball		1 2 3
Hockey		1 2 3
Baseball		1 2 3
Zip Line / Ropes Course		1 2 3
Go Carts		1 2 3
Hiking		1 2 3
Horseback Riding		1 2 3
Leadership / Team Building		1 2 3
Fossil Study		1 2 3
Computer Science		1 2 3
Camp Experience
1 Camp Name and Dates Attended
2 Camp Name and Dates Attended
References / Must have supervised you in some way / Teachers, Coaches, Church or Temple Supervisor
1 Reference / Name, Address, Phone
2 Reference / Name, Address, Phone
3 Reference / Name, Address, Phone
Enter Security Code	*
By submitting this form,(hit the Agree and Submit button) I certify that all information I provided on this application and all other information provided as part of the application and interview process is correct and true.