LEAD Summer Camp Intern Registration

Name:*
Address:*
Cell Phone:
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E-mail:*
Church Name:
Youth Pastor Name:
Emergency Contact #1:*
Emergency Contact #1 Phone:*
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Emergency Contact #2:*
Emergency Contact #2 Phone:*
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Your Personal Testimony:
Why are you applying to be a summer camp intern:
What does it mean to be a Servant Leader:
What did your youth pastor say about being an intern when you asked them:
Can you be at camp by 3:00pm on Saturday:*
If not, when can you be there: