Counselor On-line Application

Week(s) of Camp to Counsel

6-12th Super C (June 15-20)

4-6th Super C (June 23-26)

Quiz Camp (June 29-July 3)

First Name

Last Name

Street Address

City

State

Zip code

Phone

Tshirt Size

Gender

Male

Female

Birthday

Church

Pastor's Name

Pastor's Phone

Church Group/Campers to Room with

A Short Personal Testimony

By checking this box and typing my name, I acknowledge this as my electronic signature of consent for Midland Ministries to do a background check and contact my pastor as a reference. Midland Ministries is not responsible for sickness, injury, or theft of money/property during my time at camp. I give consent for camp staff to treat medical emergencies that may arise and/or call for medical assistance on my behalf.

Electronic Signature

Social Security #

Thank you for applying to serve at camp this summer! We will review your application and send you a confirmation for your week(s) of camp.

Download the Camper Information Form to see what to bring and other helpful information.

Counselor Information

Apply here to be a counselor at Super C or Quiz Camp. Counselors must be 18+ and Junior Counselors can be 16-18. Please indicate which week you're applying for and if you are coming with a specific group/church.

Counselor On-line Application

Counselor Information

CONTACT

You can also contact us by using this form:

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