Camp Sue Osborn Day Camp Application

Day Camp: June 30–July 3, 2008 (no camp on July 4) and July 7-11, 2008 At the YMCA Outdoor Family Center in Perry, Ohio
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Position Desired: Check all that Interest You, and For Which You Are Qualified

JOB:

Specialist
Counselor
Instructor

 Nurse

Aide

 Volunteer

Bus Aide

What areas of day camp instruction are you interested in?

AGES OF CAMPERS & ABILITIES PREFERRED
(CHECK ALL THAT APPLY FOR DAY CAMP ONLY)
OH AGES 4-6
OH AGES 7-15
OH AGES 16-22
LD AGES 6-15
LD AGES 16-22
DH AGES 6-15
DH AGES 16-22
MH AGES 6-15
MH AGES 16-22
HI AGES 6-22
VI AGES 6-22
SBH AGES 6-12
GIFTED AGES 6-12
PRESCHOOL SPECIAL NEEDS
Previous experience with children and young adults with exceptionalities:
Previous camping experience:
Special talents, skills, abilites which would be useful at camp:
DO YOU HAVE  
YES  NO Current CPR Training
YES  NO Current First Aide Training
YES  NO Current Child Abuse Training
YES  NO Hepatitis B Vacine, Do You Want It? YES  NO
YES  NO Teaching Certificate             Type 

BCI Fingerprinting Card YES

With whom do you have the card on file and where can we call to verify:

*If you have not been fingerprinted, you must do so prior to the start of camp.
References
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Position/Company
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Position/Company
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Phone

Positions will be filled by June 1st - For More Information Call: Susan DeGirolamo at 440-602-1037

Mission Statement

Camp Sue Osborn is dedicated to providing excellent, everyday camp experiences
for children with special needs in Lake and Geauga Counties.