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Nature Day Camp Junior Counselor Application 2019
Address Line 1
Address Line 2
For example, are you at a different address in the summer? If so, what is that address and what dates are you there?
To which email lists do you wish to be added?
General Interest (HHLT's monthly email newsletter and special announcements)
Harpswell Family Outings
Harpswell Nature Watchers
For the applicant
Applicant's Date of Birth
Which weeks of camp would you like to attend as a junior counselor? (check all that apply)
July 8-11 Preschool
July 8-12 Elementary
July 22-25 Preschool
July 22-26 Elementary
August 5-8 Preschool
August 5-9 Elementary
August 19-22 Preschool
August 19-23 Elementary
Why do you want to be a junior counselor for Nature Day Camp?
Describe your experience with children.
For a parent
Does your child have any medical or behavioral challenges that we should be aware of? Please include information about any allergies.
Emergency Contact Name
Please indicate the name of the best person to contact in case of an emergency. This can be a parent.
Emergency Contact Phone Number
Please indicate the phone number of the best person to contact in case of an emergency. This can be a parent.
Grandparents' Names, if relevant
I give permission for Harpswell Heritage Land Trust to publish photos, audio and/or video recordings taken of myself and my children during Nature Day Camp in printed publications and online.