DANIELL BAPTIST ASSOCIATION

YOUTH CAMP

BREWTON-PARKER COLLEGE

We are grateful & so blessed with the counselors who speak the Gospel into the lives of our next generation!

Please read all of the information below carefully:

If you would like to participate in this year’s SURGE CAMP as a counselor, please submit your application, background check, and a signed Child Protection Policy.

All Camp Counselors MUST submit ALL documents in order to serve.

Deadline: June 20

The Counselor’s Application can be filled out online below, or printed & mailed into the DBA office (Daniell Baptist Association, P.O. Box 388, Ailey, GA 30410).

***You will need your pastor’s signature & phone on your application. We will verify your pastor’s recommendation***

The Background Check & signed Child Protection Policy can be downloaded by clicking the links below, but they MUST be printed and mailed into, or dropped by the DBA office.

Counselor Application

Background Check Form

Child Protection Policy (After thoroughly reading, fill out and sign the last 2 pages)

The Daniell Baptist Association covers all costs for counselors.

If you have any questions please call the DBA at (912) 583‑4985 or email daniellbaptist@gmail.com

First Name^*

Last Name^*

Age^*

Gender^*

T‑Shirt Size (Adult Sizes Only)

Email^*

Phone^*

Address

Address Line 1 ^*

City ^*

State or Region ^*

Zip ^*

Church You Attend

If you are a church staff member, please list your position

Are you a Christian^*

If yes, have you followed through with that decision in believer’s baptism?

Are you comfortable leading someone in the plan of salvation?^*

Have you had any witness training?^*

Have you had the opportunity to lead someone to Christ?

Please explain why you would like to be a counselor:^*

Name of Insurance Company^*

Policy Number:

Name of Policy Holder:

List any medical conditions we need to be aware of

Will you be present the entire week?^*

If no, when will you be away?

As a counselor you will assist in being responsible for the campers at all times. Counselors will see to the physical, spiritual, and emotional well-being of campers. You will be expected to participate in all scheduled activities during camp. If you agree to all of the above, please type your name below.

I agree:^*

It is my pleasure to recommend the above named, who is a member of my church, and covered under the church’s child protection plan as a counselor for the DBA Youth Camp (which can be found here: http://bit.ly/2EYUqu9). Please type your name below if you agree.

Pastor’s Signature^*

When your application is received we will send you a confirmation letter. Please plan to attend all counselor meetings. These meetings are very important and we ask that you make every effort possible to attend them. Thank you for serving! Please be praying that God can use all of us to make a difference in the lives of the teenagers that will be attending camp.

Note: It looks like JavaScript is disabled in your browser. Some elements of this form may require JavaScript to work properly. If you have trouble submitting the form, try enabling JavaScript momentarily and resubmit. JavaScript settings are usually found in Browser Settings or Browser Developer menu. .rm_next_btn {display:none !important} .rm_noscript_btn {display: block !important}