• Five Star Life/Summit Application

    2022-2023

  • Basic Information

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  • How did you hear about us?

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  • Emergency Contact Information

  • Education

  • Previous Employment

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  • Coaching Stops

  • References

  • List at least two adults you have known for at least one year, who are not related to you or Five Star Life employees and have a definite knowledge of your character and ability to work with students.


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  • Personal History

  • Five Star Life/Summit

    Disclosure Form - Five Star Life and Summit cares about the children and youth in our programs and desires to ensure their safety while they are in our supervision. Because we care for children and youth, our organizations join in asking any new staff member or volunteer who will be interacting with children and/or youth, to complete this disclosure form. Please complete the following questions by circling the appropriate response. Please attach an explanation for any "yes" answer.

  • Health History

  • NOTE: All PARTICIPANTS must have an up-to-date signed Health History Form as well as Assumption of Risk, Liability Release, Indemnity Agreement, Picture and Video Waiver and Release to participate in any leadership experience at Summit.

    PLEASE READ AND ANSWER THE QUESTIONS BELOW: This form is intended to remind leaders and participants of the seriousness of attempting adventure activities with an old preexisting injury, a heart condition, or other condition which might be aggravated by the event. Please connect with a Summit facilitator if you need to share any additional and pertinent information.

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  • Liability Release

  • Thank you for applying with Five Star Life. Please complete our background check. You will be directed to this page after you submit your application.

    ** If you have already submitted a background check with Five Star Life, there is no need to fill out the next page. Thank you.

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