Student Camp Leader Application

*First Name

*Last Name

*Email Address

*Phone Number

*Address Line 1

Address Line 2

*City

*State/Province/Region

*Zip/Postal Code

*Grade Preference:

*Emergency Contact Name:

*Emergency Contact Relationship:

*Emergency Contact Phone Number:

*T Shirt Size:

Food Allergies:

Dietary Restrictions:

Other Allergies:

*When did you lay your faith in Christ?:

*Please explain the gospel in one paragraph.:

*Do you have experience leading a small group?:

YesNo

*What is your relationship to Sagemont Church?:

*Are there any medical conditions we need to be aware of?:

*Will you be able to financially contribute $100 by June 24th to serve at camp?:

Submit Form