2025 Summer Start Application

if you have any questions about the summer start program, please contact US AT MAIL@ao-wa-kiya.org

Section 1

Personal Information

Name

First Name

Last Name

Are you a Returning Summer Start Participant?

Date of Birth

YYYY

Age

School Grade Entering

Gender

Are You a US Citizen?

T-Shirt Size

Section 2

Contact Information

Address

(If Different)

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Best Phone Number to Contact You

Phone

(###)

###

####

Section 3

Preferences / Skills

Have You Been on Staff Previously?

If Yes, in What Way?

Please mark each of these Support Positions in your order of preference, 1 being the highest

Health Services Preference

Programming Preference

Lifeguard Preference

Media (Incl. Photography) Preference

Food Service Preference

Maintenance Preference

Groundskeeping Preference

Daycare Preference

Tech Team Preference

Please Tell Us of What Experience You Have in the Above Areas

Check all that Apply:

Certifications

Please mark the following that you have current certifications in:

Lifeguard

Lifeguard Trainer

CPR/AED

First Aid

CDL

PLEASE MARK YOUR ABILITY LEVEL ON EACH OF THE FOLLOWING AREAS

1=Very Experienced/Could Teach; 2=Some Experience; 3=No Experience

Challenge Course Ability

Rock Climbing Ability

Paintball Ability

Outdoor Life Ability

Horsemanship Ability

Worship Ability

.22 Riflery Ability

Air Riflery Ability

Archery Ability

Woodcraft Ability

Handcrafts Ability

Photography/Video Ability

Sailing Ability

Canoeing Ability

Fishing Ability

Swimming/Water Obstacle Course Ability

Wakeboarding Ability

Kayaking Ability

Please Tell Us of What Experience You Have in the Above Areas

Section 4

References

Reference 1 (Spiritual Mentor)

Must be a Pastor or a Small Group Leader

Reference 1 Name

First Name

Last Name

Reference 1 Relationship

Reference 1 Email

Reference 1 Phone

Years Known Reference 1

Reference 2

Must be non-relative

Reference 2 Name

First Name

Last Name

Reference 2 Relationship

Reference 2 Email

Reference 2 Phone

Years Known Reference 2

Reference 3

Must be non-relative

Reference 3 Name

First Name

Last Name

Reference 3 Relationship

Reference 3 Email

Reference 3 Phone

Years Known Reference 3

Section 5

Spiritual Maturity

How have you grown spiritually in the last year?

Church Affiliation

Your salvation experience

Your prayer and devotional life

Final Section

Wrap-up Questions

Have you been convicted of a crime?

(other than minor traffic violations)

If yes, please explain:

Do you have any physical limitations?

Do you have any communicable disease?

If yes, please explain:

Additional Comments

Realizing the great responsibility and opportunity of working with children at Camp Ao-Wa-Kiya, I agree to: Sacrifice personal desires in the interest of the campers; Cooperate with the directory and other leaders under whom I serve; Obey camp and staff regulations printed in the staff manual; Endeavor to be a blessing to the campers with whom I work by helping to enrich their lives spiritually, physically, and mentally; and Uphold the standards and doctrinal position of Camp Ao-Wa-kiya (a copy of the doctrinal statement may be obtained at ao-wa-kiya.org). I hereby release and agree to hold harmless from liability any person or organization, whether listed or not, who provides information or references about me to Camp Ao-Wa-Kiya. I waive any right I might have to inspect references provided on my behalf. I certify that I have neither been convicted of, nor am I the subject of pending charges, for any offence involving actual or attempted child abuse or sexual molestation in any jurisdiction.

Staff Agreement

I Agree to the statement above