OHIO STATE UNIVERSITY EXTENSION

Transcription

1 2019 Clark Co. 4-H Camp Counselor/CIT Application Due by October 31, 2018 to OSU Extension, Clark County Office 3130 East Main Street, Springfield, OH Phone: Fax: Who is Eligible to Apply? CIT/Ambassador Applicants: Must be at least 14 years old and in at least the 8 th grade as of Jan. 1, Counselor Applicants: Must be 16 years of age or older as of Jan. 1, What You Must Do To Apply? Review the Camp Counselor/CIT Position Descriptions. Complete & sign the Camp Counselor, CIT, Ambassador Application. Provide three non-family references with contact information. This is required for ALL applicants! Read and Sign the following: 4-H Camp Commitment & Contract, Ohio 4-H Camp Counselor Code of Conduct, Ohio State University Standards of Behavior for Minor Participants Participating with Minor Participants Participate in an interview & group assessment based mark appropriate day and time below. Group Interviews & Assessments: If you have a conflict, please call or house.18@osu.edu. All Returning Applicants will participate in a small group assessment & interview session. Select a time from these options. Sun., Nov. 4, 2018: 1 PM 2 PM 2 PM 3 PM Mon., Nov. 5, 2018: 5 PM-6 PM 6 PM-7 PM 7 PM-8 PM All First Time Applicants Group Assessment and Interviews will be held on Sunday, Nov. 4, 2018 Choose one of the following times: 3 PM 4 PM 4 PM 5 PM 5 PM - 6 PM Selection Notification: Applicants that complete the entire process notified of selection results by Nov. 20, Questions: Call or Patty at house.18@osu.edu First Name Middle Initial Last Name: Address City / Zip Age as of 1/1/2019 Current School Grade: School: Gender: Male Female 4-H Member: Yes No 4-H Club: Home Phone Number: Address: Cell Phone Number: Is texting an option? Yes No This is my first year to apply. Yes No # Years as: Camper Ambassador CIT Counselor 2019 School Calendar (if known): Dec. Holiday Break Spring Break Homecoming Last Day of School Share other activities that will require your time. Check all that apply. Job FFA Jr. Fair Board Band Choir Other Sports school or leagues list sports: In case of emergency or accident, notify: Name: Relationship: Phone #: Why do you want to be a camp counselor? What skills or contributions will you add to the counselor team in making sure camp is successful? Specialized Training: List most current certification date CPR First Aid Shooting Sports Team Challenge Lifeguard Other Page 1/5 4-H Camp June 21-25, 2019

2 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 hobbies and/or special interests do you have that you would like to share? List 2 of your strengths. Offer a Theme Idea and then complete one area below with your ideas for a dynamic 4-H Camp Program. You may ask family and friends, your 4-H club or even do some searching on your own. May add additional paper as needed! My Theme Idea is Area 1: Workshop Ideas (45 minute session) CAN T LIST ONES DONE AT CAMP IN THE LAST 5 YEARS! Area 2: Alternatives/Games to Afternoon or Evening Programs: CAN T LIST ONES DONE AT CAMP IN THE LAST 5 YEARS! References: List 3 persons not related to you that have knowledge of your qualifications. Examples: 4-H advisors, teachers, coaches, community/youth group leaders, neighbors, employers, principals, etc. You may not use minors as references! Name: Relationship to You: Home Phone: Cell Phone: Address: City: Zip: Name: Relationship to You: Home Phone: Cell Phone: Address: City: Zip: Name: Relationship to You: Home Phone: Cell Phone: Address: City: Zip: I authorize the contact of listed references and understand that if I am 18 or older will be required to submit to a fingerprint criminal background check prior to service as a 4-H Camp Counselor/CIT/Ambassador. I understand that misrepresentation or omission of required information is just cause for non-appointment as a 4-H Camp Counselor/CIT/Ambassador with Ohio State University Extension. I understand that I serve at the pleasure of the Ohio State University Extension and agree to abide by the policies of Ohio State University Extension, the 4-H Program and to fulfill the volunteer and counselor responsibilities to the best of my ability. Applicant Signature: Date: Parent/Legal Guardian Signature: Page 2/5 Date:

3 2019 Clark Co. 4-H Camp Counselor/CIT Commitment & Contract Return with Completed 4-H Camp Counselor/CIT Application I will: Maintain my Clark County 4-H membership in good standing and/or become a Clark County 4-H member in good standing for the H Year. Attend the 2019 Camp Counselor & CIT Orientation on Tuesday, Nov. 27, 2018, 6 PM-8:30 PM at the Extension Office. Complete the required 24 hours of counselor/cit training and 4-H camp planning hours and/or the required ambassador training hours including the Child Abuse Awareness training. Record training dates in my calendar and make them a priority. I understand that I will not attend 4-H camp as a counselor or CIT, if I do not meet the required training requirements. Contact the Clark County Extension Office or Camp Director(s) by phone, or text if I am unable to attend any of the scheduled counselor/cit training or planning sessions. Show respect and communicate with camp staff (professional and volunteer), fellow counselors, CIT s, and campers to minimize misunderstandings and problems. Be on time, flexible and responsible to meet camper needs and carry out counselor, CIT duties and responsibilities. Be a TEAM PLAYER by: Being an ACTIVE participant in planning 4-H camp: workshops, campfire, evening recreation, flag ceremonies, inspiration, free time, cabin time & special programs. Being PREPARED for any camp activity (self-selected or staff appointed to meet a need). Being COMMITTED to do my part to plan, conduct and evaluate a successful camping experience for all. Serve as a positive role model by: Not using profanity or telling off color jokes and stories. Not using or possessing tobacco products, alcohol or illegal drugs. Not committing a criminal act. Not belittling, ridiculing or being abusive (physical, verbal or emotional) to others. Follow and enforce safety guidelines, 4-H and camp rules at all times to ensure the safety of all. Supervise campers at all times in cabins and groups, during activities and free time, off site at specials, to and from activities, nurse s cabin or the bathroom. Be responsible for my own behavior and actions. Be in my cabin with my campers at all times between the hours of Lights Out and Rise and Shine. Get to know each camper and encourage camper participation to help campers make new friends. Turn my cell phone OFF during training and planning sessions. Turn my cell phone in upon arrival at camp and only request cell phone use for emergency communication unless otherwise authorized by camp staff (professional and volunteer). Abide by the no cell phones and/or electronic devices with camera capability in the cabins at camp policy! Pay any fees associated with my volunteer role as a Camp Counselor/CIT by June 15, Estimated fees: Counselor 30% of Camp Fee CIT 50% of Camp Fee If 18 years of age or older at least 2 months prior to camp, I understand I must submit to a BCI Fingerprint Check no later than May 15, I understand that I will be reimbursed for this expense. My signature acknowledges that I have read and agree to abide by the above Counselor/CIT contract and responsibilities. I understand and agree that if my performance during training and planning sessions or at 4-H camp is not acceptable and/or I am not meeting the responsibilities and expectations outlined above, I will be dismissed. Counselor/CIT Signature: Date: I have read and agree to support my son or daughter in these roles as a 4-H Camp Counselor or CIT. I understand the expectations and responsibilities outlined above as well as the consequences, if these are not fulfilled by my child. Parent/Legal Guardian Signature: Date: Page 3/5

4 OHIO 4-H CAMP COUNSELOR/CIT CODE OF CONDUCT Return with Completed 4-H Camp Counselor/CIT Application I, agree that if selected, I will participate in the Clark County (county above) 4-H Camp Counselor/CIT Training Program. I understand that this is a training period and only once I complete my certification am I permitted to be a counselor/cit 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 above responsibilities 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 (note: unless otherwise authorized by Extension staff) 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 time. 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. Participate in camp promotion. Follow leadership of camping program through adult advisors/volunteers/staff. 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/ Legal Guardian Signature Page 4/5 Date

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