Junior Mentor Application

At Spences Farm Junior Mentors assist the Mentors with our daily duties, including (but not limited to): Mentoring Rainbows & Trailblazers, Working in the Garden, Assisting with Horsemanship Lessons, Feeding Goats and Chickens, and Farm House Chores. Ages 13-16.

General Information

Name *

Age *

Date of Birth *

Address *

Phone Number *

Email *

Have you been a camper at Spence's Farm? If so, for how many years? *

Have you been a Junior Mentor at Spence's Farm? If so, for how many years? *

Which weeks this summer will you be attending. You may attend partial weeks. Please list all and which are full and which are partial. Note there is a 1 time registration fee of $175. You may attend as many weeks as you are able for no additional fee. *

How did you first learn about Spence's Farm Junior Mentor Progam? *

Why do you want to be a Junior Mentor? *

What area at the farm would you like to be Junior Mentor? We will be assigning you to more than one area. *

Personal Information

Who or what has had the most influence in your life? *

Tell us about yourself. What are your hobbies, talents, skills and interests? Don't be afraid to talk about yourself! *

What do you hope to gain from this experience? *

List and describe any experience you have had working with children *

List any clubs, groups, or programs that you are or have been involved with. *

Do you have any experience with horses? Riding, grooming, handling, and leading? Explain. If no, would you feel comfortable in helping with the horses when needed? *

Personal References
List two persons who are not relatives, and one who is a relative

Name *

Phone # *

Relationship to you *

Name *

Phone # *

Relationship to you *

Name *

Phone # *

Relationship to you *

Person to be contacted in case of emergency or illness:

Name *

Phone # *

Relationship to you *

Under North Carolina law, there is no liability for an injury to or death of a participant in an agritourism activity conducted at this agritourism location if such injury or death results from the inherent risks of the agritourism activity. NC G.S. 99E-30

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