First Name

Last Name

Email *

Cell Phone # *

Address

Street Address

City

State

Country

Postal Code

Date of birth

Please add a profile picture

PDF, DOC/DOCX, XLS/CSV, JPG/JPEG, PNG, GIF

Are you 21+?

Yes

No

Have you been to Club Getaway before? (copy)

Yes

No

Have you been on the Crew before?

Yes

No

Have you ever been arrested, charged or convicted of a felony or sexual assault?*

Yes

No

If Yes, Please provide more information.

Have you ever been to or worked at a summer camp?

Yes

No

If Yes, which camp?*

Why do you think you would be great crew member?

Tell us about a special moment you had at Club Getaway. Why is CG important to you?

Anything else you feel is important for us to know about you?

Are you able to take the bus to Club Getaway from New York City?

Yes

No

Would you be able to be the Bus Captain?

Yes

No

Are you able to lead a Fitness or Dance Class?

Yes

No

If Yes, what type of fitness or dance class?

Any other sports, hobbies, interests that could be added to the schedule?

Emergency Contact

Emergency Contact Phone Number

Emergency Contact Relationship

Signature