| Please read application form carefully. |
Applicant's Name: ____________________________________ Age: _________________
Mailing Address: _______________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
Telephone #: (Home) ________________________ (Work)________________________
APPLICANT MUST BE AN IMMERSED BELIEVER
Reference/Endorsement by Church Leadership
Church applicant attends: _________________________________________________________
Church Address: ________________________________________________________________
________________________________________________________________________________
Minister/Elder: ______________________________________ Telephone #: __________
"The applicant ______________________________ is known to attend services in our congregation and is of commendable Christian character, suitable to serve at Canoe Cove Christian Camp with the blessing and encouragement of the Leadership of this Church."
Signature of Church Leader:____________________________________________
(Minister/Elder)
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
| Name | Relationship | Phone Number |
| _____________________________ | ________________________ | ________________________ |
| _____________________________ | ________________________ | ________________________ |
| _____________________________ | ________________________ | ________________________ |
If "Yes", tell how often and describe it: __________________________________________
___________________________________________________________________________
___________________________________________________________________________
Do you participate in a leadership position at your church? No ____ Yes ____If "Yes", in what capacity? ____________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
"I have read and do hereby understand and agree to abide by all the conditions set forth in this form and by all the camp's rules and regulations if accepted to serve at the camp."
Applicant's Signature: __________________________________ Date: _______________
CANOE COVE CHRISTIAN CAMP
Staffing & Programming
P. O. Box 661
Charlottetown, PE C1A 7L3
(902) 675-3039