OHIO STATE UNIVERSITY EXTENSION

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1 EVENT/OPPORTUNITY: 4-H Camp Counselor DATE / DEADLINE: Applications are due to the OSU Extension Office by 4:00 p.m. on Friday, Jan. 11 th, LOCATION of PROGRAM: Tar Hollow State Park, Laurelville, Ohio for Junior and Intermediate Camps and Alley Park, Lancaster, Ohio for Cloverbud Day Camp. PROGRAM DESCRIPTION: The 4-H Camp Counselors are a group of 4-H teens selected to assist in being responsible for campers ages (Intermediate Camp), ages 8-10 (Junior Camp) and ages 5-8 (Cloverbud Camp) during 4-H camp. As a result of participation, counselors will develop knowledge, skills, attitudes and aspirations needed for adult success, and the Fairfield County 4-H Program will be strengthened and expanded. Roles and Responsibilities of 4-H Camp Counselors include: Attend required trainings prior to camp. Market and promote camp. Serve in a leadership and teaching role to other counselors. Serve on a team or other groups to plan and implement programs at camp. Conduct self in an appropriate manner before, during, and after camp while serving as a role model to campers and peers. Assist staff and other counselors with camp activities; work as a team to implement the activities. Know and understand all safety guidelines, including emergency procedures, associated with the camp and program areas. Follow and enforce camp rules. Assure the safety of campers at all times including in cabins, sessions, and large group activities. Be aware of child protection regulations and report any child abuse, sexual abuse, or neglect in accordance with university policy. Identify and respond to camper behavior issues. Ensure campers health and hygiene, e.g., brushing teeth, eating meals, taking medication, etc. Promote camper participation during camp. Lead and supervise campers in activities at camp including but not limited to songs, teambuilding challenges, group activities, games, challenges, etc. Teach and lead campers at workshops or during other components at camp (crafts, line dancing, canoeing/kayaking, table setting, camp clean-up, song leading, etc.). Mentor and give guidance to campers to encourage positive youth development and enhancement of life skills. Be on time at meals, workshops, sessions, and activities. One counselor must sleep in a bed next to the cabin door (only applies to Tar Hollow Intermediate and Junior Camps). REQUIREMENTS: Must be a 4-H member in good standing. Must be at least 14 years old by the start of camp. Must be able to get transportation to and from meetings and events as needed. Junior and Intermediate Camp Counselors must complete a minimum of 24 hours of training (6 of these hours must be onsite at Tar Hollow) Cloverbud Camp ONLY Counselors must complete a minimum of 12 hours of training (2 of these hours must be onsite at Alley Park). Must complete Child Abuse Awareness training. Must Sign Standards of Behaviors, Code of Conduct, Counselor Permission to Participate Fairfield County 4-H Camps, and have a current Ohio 4-H Health History form on file. Applicants must provide two references (with at least one completed by your 4-H Advisor). If the individual is 18+ year old at least two months prior to camp, the individual must have their background check conducted. SELECTION PROCESS: Individuals who complete the application and fulfill application requirements will be contacted regarding the selection process.

2 JUNIOR & INTERMEDIATE CAMP COUNSELORS MEETING DATES/TIME/FREQUENCY JUNIOR and INTERMEDIATE Camp Counselors are REQUIRED to meet the following dates throughout the year. January 12 th Ag Center 9:00-11:00 a.m. *Interviews and Selection *New counselors and returning counselors starting their second year February 12 th Ag Center 6:30 8:30 p.m. *New Counselor Orientation *New counselors and returning counselors starting their second year February 18 th Ag Center 12:30-5:00 p.m. Program Planning for Junior & Intermediate Camp Counselors March 27 th Ag Center 6:00-7:00 p.m. 7:00-8:00 p.m. 8:00-9:00 p.m. Program Planning: Intermediate Camp Teams Training: All Camp Counselors Program Planning: Junior Camp Teams April 6 th Ag Center 9:00am-3:30pm Counselor Training Day This is in place of the Overnighter April 10 th Ag Center 6:00-7:00 p.m. 7:00-8:00 p.m. 8:00-9:00 p.m. April 24 th Ag Center 6:00-7:00 p.m. 7:00-8:00 p.m. 8:00-9:00 p.m. Program Planning: Intermediate Camp Teams Training: All Camp Counselors Program Planning: Junior Camp Teams Program Planning: Intermediate Camp Teams Training: All Camp Counselors Program Planning: Junior Camp Teams May 22 nd Ag Center 6:00 8:00p.m. Final Program Planning: Intermediate & Junior Camp Teams June 11 th June 22 th May and June - Additional Camp Planning for Teams as needed! Tar Hollow Laurelville, OH Tar Hollow Laurelville, OH TBA Tar Hollow Counselor s Camp (Cost TBA) Required for all Junior and Intermediate Counselors 3:00-4:30 p.m. Fairfield County Intermediate Camp Staff and Counselor Move-In June 23 rd - 26 th Tar Hollow Laurelville, OH Fairfield County Intermediate Camp June 30 th July 1 st 4 th Tar Hollow Laurelville, OH Tar Hollow Laurelville, OH 3:00-4:30 p.m. Fairfield County Junior Camp Staff and Counselor Move-In Fairfield County Junior Camp August 7 th Ag Center 6:00 8:00 p.m. Counselor Fun Night Counselors are expected to notify the Extension Office if an absence is unavoidable.

3 CLOVERBUD CAMP COUNSELORS MEETING DATES/TIME/FREQUENCY CLOVERBUD Camp Counselors are REQUIRED to meet the following dates throughout the year. January 12 th Ag Center 9:00-11:00 a.m. *Interviews and Selection *New counselors and returning counselors starting their second year February 12 th Ag Center 6:30 8:30 p.m. *New Counselor Orientation *New counselors and returning counselors starting their second year February 18 th Ag Center 9:00 a.m. - 12:00 p.m. Program Planning for Cloverbud Camp Counselors April 6th Ag Center 9:00a.m. - 3:30 p.m. Counselor Training Day This is in place of the Overnighter May 22 nd Ag Center 6:00-8:00 p.m. Final Program Planning and Training: Cloverbud Camp Counselors May and June - Additional Camp Planning for Committees as needed! June 5th Alley Park 4:00-8:00 p.m. Picnic, Onsite Training and Final Planning: Cloverbud Camp Counselors June 15 th Alley Park 9:00 a.m. 4:00 p.m. Cloverbud Day Camp August 7 th Ag Center 6:00 8:00 p.m. Counselor Fun Night Counselors are expected to notify the Extension Office if an absence is unavoidable.

4 MEETING DATES/TIME/FREQUENCY (continued): 4-H Camp Counselors can optionally participate in the following Camp Counselor Training Opportunities in 2019: Making extreme Counselors on February 23 rd & 24 th, 2019 (time to be announced) at the Nationwide and Ohio Farm Bureau 4-H Center in Columbus, Ohio. Separate registration information must be completed and there will be a fee (amount to be determined) for this training to be paid by the Camp Counselor. MXC Registration will be due to the OSU Extension Office on Wednesday, January 30 th, Ohio 4-H Conference on March 9 th at the Columbus Convention Center in Columbus, Ohio (time to be announced). Separate registration information must be completed and there will be a fee (amount to be determined) for this training paid by the Camp Counselor. If the Ohio 4-H Achievement Form is completed, part of this fee will be reduced for the Ohio 4-H Conference. Ohio 4-H Conference Registration will be due to the OSU Extension Office on Tuesday, February 5 th, Counselors are expected to notify the Extension Office if an absence is unavoidable. SUPERVISOR: 4-H Camp Counselors report directly to the Camp Director with supervision by the entire camp staff. BENEFITS: Develop leadership skills, gain self-confidence, assist in personal development of younger 4-H members, meet new friends, reduced camp fees. TO APPLY: Complete the application packet in its entirety. Turn in completed reference forms from two non-family members (one must be completed by your 4-H Advisor). Read, sign, and return your Application. Read, sign, and return your Standards of Behavior Form. Read, sign, and return your Camp Counselor Code of Conduct Form. Read, sign, and return your Counselor Permission to Participate Fairfield County 4-H Camps Form. Read, complete, sign, and return your Ohio 4-H Health Statement (with picture attached). Return all materials to the Fairfield County Extension Office by Friday, January 11 th, 2019 at 4:00 p.m. (no exceptions).

5 FAIRFIELD COUNTY 4-H CAMP COUNSELOR APPLICATION Name: Age (January 1, 2019): Date of Birth: (00/00/0000) Home Address: (Street) (City) (State) (Zip) Home Phone: Cell Phone: Is texting an option? (circle) Yes No 4-H Club: Years in 4-H: School Attending: Grade: In case of injury or accident, notify: Name: Relationship: Phone: 4-H Project Experience: What 4-H project(s) did you take and complete last year (2018)? This does not include any FFA or other school or community projects taken. Please note it is required to complete a 4-H project a year prior to counseling at 4-H camp! Basic Camp Information: Years attended 4-H Camp as a Camper Years as a 4-H Camp Counselor Why do you want to be a Camp Counselor? What traits, skills, or special experiences do you have that would benefit you in this position? (Please include experiences working with children and youth.) What skills or contributions will you add to the counselor team in making sure camp is successful? (such as First Aid, Babysitter s Course, Recreation, etc.) 3 words that a friend would use to describe you:

6 List and describe a leadership experience you have had: What hobbies and/or special interests do you have that you would like to share? Please list 2 of your strengths: Please list 2 of your weaknesses: Each year the counselors and adult staff select a timely and fun camp theme and plan the camp activities and programs around the theme. Using a camp theme you would suggest, complete the following camp plan. (The themes listed will be the themes discussed at the planning meetings.) CAMP THEME: SUGGESTIONS FOR PROGRAM IDEAS REGARDING THIS THEME (Group names, Guest Speakers, Activities, etc.) Camp Planning Information: Please mark your preference on the camps you would like to be considered to counsel at. Please select one option for each section. (Make sure you are age eligible before selecting!) Section 1 Intermediate Camp Only (must be 15 years old as of 6/22/2019) June Counselors & Staff will come June 22) Junior Camp Only (must be 14 years old as of 6/30/2019) July 1-4 Counselors & Staff will come June 30) Intermediate Camp AND Junior Camp (I would like to counsel at both camps, if possible) Intermediate Camp OR Junior Camp (I do not have a preference, but I only want to counsel at one of the camps.) Section 2 Cloverbud Day Camp Counselor June 15 (must be 14 years old as of 6/14/2019 will work with campers day of camp.) Cloverbud Day Camp Workshop Leader June 1 (must be at least a 2 nd year counselor in 2019 will lead a workshop during camp.)

7 Counselor Permission to Participate Fairfield County 4-H Camps I give permission for my child (name) to participate in Fairfield County 4-H Camp(s) at OSU Extension/Ohio 4-H Center/Tar Hollow State Park/Alley Park on (circle dates) June 5, June 11, June 15, June 22, June 23-26, June 30, July 1-4. Activities involved in camp will include living in a cabin on a hill; sharing bathroom facilities with other campers on the hill; sleeping in bunk beds; canoeing and swimming in a pond; nature hikes; playing volleyball, basketball, relay races and other recreational games; campfire activities; and dances. Attending camp may lead to contact with individuals who are experienced and inexperienced in the above mentioned activities. I also understand that participation in this activity is strictly voluntary and not a requirement for 4-H membership. I am aware, and have discussed with my child, that: A. Being in and around water, woods, and participation in camp activities may cause clothing to become wet, dirty, and beyond cleaning and/or repair; B. While in a canoe, my child may be involved in a collision with another canoe, person, or object in the water; C. Hiking may give rise to risk of injury arising from the surface or subsurface of the ground on which the hiking occurs; D. Participation in sporting/recreational events may give rise to injury as a result of collisions with another individual or sudden falls; E. Other participants may act in a negligent manner which otherwise may result in harm to my child; F. Swimming in a pond may lead to injury caused by slippery surfaces, contact with other swimmers and/or objects in the water. I recognize that the above mentioned activities and potential resulting risks may cause injury, death, drowning, or loss to participants or other persons in the immediate vicinity. I understand that my child is not required to participate in this activity, but grant permission for him/her to do so, despite the possible risks. I recognize that by participating in this activity, as with any physical activity, my child may risk personal injury. I hereby attest and verify that I have been advised of the potential risks, that I have full knowledge of the risks involved in this activity, and that I assume any expenses that may be incurred in the event of an accident, illness, or other incapacity, regardless of whether I have authorized such expenses. Fairfield County 4-H Camp Rules 1. Report all sickness & injuries to the nurse at once. 2. No swimming or canoeing when the lifeguard is not present. 3. Shoes must be worn at all times (except when showering, sleeping or swimming). 4. No running on trails or hills. 5. Respect others and their property. Use language and manners that are respectful. 6. No fighting. 7. Remain in your own cabin. No one is permitted on hills during program, recreation, campfire, etc. time. No one is permitted on a hill other than their own. 8. Everyone must be in their cabin and quiet by lights out, and remain there until 6:30 a.m. Quiet hours are from lights out until 8:00 a.m. If you are someplace other than in your cabin, the bathroom, or the nurse s station after lights out, you will be sent home. 9. A raised hand means to listen. When you see someone with a raised hand, you also raise your hand, be quiet and listen for instructions. Be quiet when appropriate and help keep campers quiet. 10. State law prohibits possession of alcohol, drugs, fireworks, and firearms at the state park. Tobacco products are also not permitted at camp. Anyone is possession of such items will be immediately sent home. The park ranger will also be notified. I understand and have explained to my child the behavior that is expected during their participation in the Fairfield County 4- H Camp. I also understand and have explained to my child that not following the above stated rules may require them to call me to explain their behavior and pick them up from camp. Signed Signed (Parent/Guardian) (Counselor) Date Date

8 Ohio 4-H Camp Cell Phone Policy (Ohio 4-H Policy effective October 2015) As a means of risk management, youth participants (campers and counselors) may not possess cell phones* during 4-H camp. Counselors shall not use cell phones (as alarms, music players, etc.) in their cabins at any time. Camp Program Directors have discretion for permitting camp counselors selective cell phone use during limited time periods, such as during out-posting, nature treks, or off-camp travel (field trips), or for other safety concerns where the use of two-way radios is not practicable. Camp Program Directors will determine consequences for possessing a cell phone. The State 4- H Office recommends a zero tolerance approach: If an individual is caught with a prohibited cell phone, they will be sent home at the family's expense. *Camp Program Directors also have discretion for prohibiting other internet-enabled devices at their 4-H camps. The Fairfield County Camp Director recognizes the Ohio 4-H Camp Cell Phone Policy. However, Fairfield County Camps will abide by the Tar Hollow Electronics Policy as we will prohibit other electronic devices as outlined below: TAR HOLLOW ELECTRONICS POLICY FOR CAMPERS AND COUNSELORS (Approved by the Ross Hocking Extension Camp Board 3/27/2014) Cell Phones: Campers and counselors shall NOT bring any kind of cell phone to camp. Cell phones do not have reception at camp, and their use as cameras is prohibited. Music players: Counselors and staff may bring music players, radios, and ipod type devises but only for use in the cabins as alarm clocks and for music. Counselors may use ipod type devices outside of the cabin only at dances where the counselors are serving in a DJ capacity. In addition, ipods may not be used to play games or in a cell phone like capacity for texting, photos, or internet purposes. Other electronics: Campers and counselors shall NOT bring any other handheld game, laptop, or other communications devices capable of accessing the Internet through Wi-Fi or another external network. Cameras: Campers may bring cameras to camp provided that they cannot upload pictures to the Internet. Due to the nature of camp programs, a disposable or inexpensive camera is highly recommended. MESSAGE TO PARENTS: We know in this high-tech era that it s difficult for youth to not be in constant contact with their families and friends via Facebook, texting, or cell phone calls. However, camp is a unique experience. The camp experience helps youth develop life skills including independence and self-reliance. Among the concerns that make bringing and using cell phones and other communication devices inappropriate at camp are: Concern that such expensive devices will be lost, damaged, or stolen. OSU Extension, camp, and staff cannot accept responsibility for lost, stolen, or damaged items at camp. Inappropriate use of photo and video devices. We know from media reports that the ease of uploading inappropriate photos and videos is a concern. Cyber bullying is not permitted before, during, or after camp. In addition, youth contact with home if they are suffering a temporary spate of homesickness at camp may cause the condition to worsen. We fully appreciate and respect the positive relationships our campers and counselors have with their families, but if they are to benefit fully from the camp experience, they must be encouraged to develop the skills of independence and self-reliance. If there is an emergency, or if we are concerned about the youth s well-being, we will contact the parents or guardians immediately. Campers are constantly in the company of other campers and counselors while at camp, and our camps are staffed with many caring adults, including an experienced camp nurse. Thank you for your cooperation with our electronics policy.

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10 4-H CAMP COUNSELOR CODE OF CONDUCT I, agree that if selected, I will participate in the 4-H Camp Counselor Training Program. I understand that this is a training period and only once I complete my certification am I permitted to be a counselor at 4-H Camp. I understand that I am taking on a different role at camp. I am applying to serve others, not to go purely for my own enjoyment. By signing below, I acknowledge that I have read and agree to abide by the requirements, responsibilities, and expectations listed in this application packet if selected as a camp counselor. I understand and agree that I will be asked to call my parents/guardian immediately to pick me up if I conduct myself in an irresponsible manner, which includes being out of my cabin after hours and/or the possession or use of tobacco, alcohol, illegal drugs or fireworks. I will be expected to: Attend the required number of counselor training sessions. I understand I will be dismissed if I am not able to complete the required training. Abide by the No Cell Phones at Camp Policy and Tar Hollow Electronics Policy. Treat other peers with respect. Not bully fellow counselors or participate in goat-play or hazing. Conduct myself as a positive role model and be responsible. Set a good example by not using profanity or telling off-color jokes, and stories. As a 4-H member, not have in my possession tobacco, alcohol or illegal drugs. Not have possession of harmful objects without specific authorization from the camp director, including but not limited to: knives of any kind (pocket, utility, etc.), lighters, matches, fireworks, explosives, firearms, weapons, etc. No pornography or other sexually oriented materials including nudity in visual or written materials including similar content. Be a responsible cabin counselor and ensure campers are provided guidance towards a safe and fun week. Ensure that all campers are supervised by counselor staff at all times. Be sure that all campers know that they must remain on the camp grounds at all times and are responsible for their behavior at all times. o Get to know each of the campers personally and by name. o Have all campers, including myself check in any of their medications with the nurse. o Make sure each camper uses personal hygiene. o Make sure that all of my campers are familiar with camp facilities and camp rules. o See that all campers are involved in all activities. Make sure no one is excluded. Check for illness or injury, but don't make much of a "fuss" about minor things. Go with hurt or sick campers to the nurse no matter how minor the ailment. Follow guidelines for lights out, and cabin supervision. Be in my cabin with my campers at all times between the hours of "Lights Out" and "Rise and Shine. Never discipline a camper by ridicule or physical punishment; patience and understanding works best. Urge safety at all times. Take time to explain how and why to do something safely. Work as a team to plan, organize and conduct all camp activities. Be flexible with counseling and adult staff (plans do change and rains do come). Participate in camp promotion. Follow leadership of camping program through adult advisors/volunteers/staff. Feel free to discuss problems with the Camp Director. I certify that the all the information being submitted is correct, and understand that failure to comply with these rules could result in probation, or loss of counseling position for the year. Applicant s Signature Date / / Parent/ Guardian Signature: Date / /

11 REFERENCE FORM is applying as a camp counselor at 4-H Camp this summer. The camp counselor selection committee would like your input about the qualities and ability to fulfill the responsibilities of a counselor. The information you include will not be shared with the applicant. Please complete this reference form based on your knowledge and/or observations. Thank you for your help. 1. Please mark how you would evaluate the applicant s qualities, using this scale: Excellent Good Fair Poor Not Known Responsibility Communication skills Respect for others Dependability Enthusiasm Flexibility Patience Initiative Resourcefulness children (age 5-10) children (ages 11-14) other teens adults 2. Please write any additional comments here: Signed: Printed Name: Relationship to Applicant: Date: Please return no later than January 11, 2019 at 4:00 p.m. OSU Extension, Fairfield County Address: 831 College Avenue, Suite D, Lancaster, OH Fax: cooksey.25@osu.edu or fowler.443@osu.edu Please note: Please submit in a sealed envelope. For questions contact the OSU Extension Office.

12 REFERENCE FORM is applying as a camp counselor at 4-H Camp this summer. The camp counselor selection committee would like your input about the qualities and ability to fulfill the responsibilities of a counselor. The information you include will not be shared with the applicant. Please complete this reference form based on your knowledge and/or observations. Thank you for your help. 1. Please mark how you would evaluate the applicant s qualities, using this scale: Excellent Good Fair Poor Not Known Responsibility Communication skills Respect for others Dependability Enthusiasm Flexibility Patience Initiative Resourcefulness children (age 5-10) children (ages 11-14) other teens adults 2. Please write any additional comments here: Signed: Printed Name: Relationship to Applicant: Date: Please return no later than January 11, 2019 at 4:00 p.m. OSU Extension, Fairfield County Address: 831 College Avenue, Suite D, Lancaster, OH Fax: cooksey.25@osu.edu or fowler.443@osu.edu Please note: Please submit in a sealed envelope. For questions contact the OSU Extension Office.