Junior Counselor Application Form - 2017 (Page 2 of 12) in pdf

Girl Scout Council of the Nation's Capital

Junior Counselor

GIRL AND PARENT AGREEMENT

I agree to submit three references to the council office, using the form provided. Ask your Girl Scout Leader,

another Girl Scout adult, and one non-Girl Scout adult. At least one person must know of your ability to work with

young girls and at least one must attest to your camping experience. Have the referee complete the reference

and return it to you. You may also give reference forms in a stamped envelope addressed to: Emily Reece,

Camping Specialist, GSCNC, 4301 Connecticut Ave., NW, Washington, D.C. 20008

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I will be sensitive to the needs of each group member, camper and staff.

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I will respect the places and the people with whom I come in contact. I will not use profanity in speaking

with people.

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I understand that the use of tobacco, alcohol or drugs will not be tolerated, and that usage during the

program will result in expulsion from the program.

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I will be responsible for my personal belongings and will not hold the Girl Scout Council of the Nation's

Capital responsible for their loss or damage.

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I will treat all equipment provided for my use with care. I understand that I will be assessed for damages

to any equipment in the event that my use of such equipment is negligent or abusive.

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I will use all required safety equipment and follow safety rules and procedures.

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I understand that if I am sent home early due to misconduct, it will be my parent's or guardian's

responsibility for picking me up at camp. I will have to meet with my parents or guardians and the Camp

Director if I would like to be readmitted to the program.

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I understand in order to receive Girl Scout recognition; I will need to keep the appropriate documentation

and evaluation of my experience.

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I understand that supervision will not be provided on weekend breaks, and I will be required to leave

camp.

Signed________________________________________________________________ Date __________

(girl applicant)

I have read the application and materials and give my daughter permission to participate in the JC program. I will

also need to sign a special permission slip allowing my daughter to participate in this program. I understand and

agree with the above responsibilities of my daughter.

Signed ________________________________________________________________ Date ___________

(parent/guardian)

JCApplication2017

Junior Counselor Application Form - 2017 Page 2