Clone of Returning Staff Application 2022

Returning Staff Application 2022

Please complete the form below to apply for a position with us.
Full Name *

First Name Middle Name Last Name
Birth Date: *

Month Day Year
Sex: *

Male Female
Home Mailing Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
School District of Home Address
College Mailing Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Last Date at College Address
MM/DD/YYYY
Phone Number *

Area Code Phone Number
Email Address *
That you check!
Parents' Name(s): *

First Name Last Name
Parents Phone Number *

Area Code Phone Number
Parents' Name(s):

First Name Last Name
Parents Phone Number

Area Code Phone Number
Church (membership) *
with city/state
Church (Currently Attending) *
with city/state
Staff Positions
Check which positions in which you are willing to serve: (pick 3) *
*This position is generally combined with another position.
Staff Training
Staff Training is required and Leadership Training is by invitation:

Leadership Training- May 31-June 3

Staff Training- June 6-10
Summer Camp
Check the camps that you are available: *
Personal Skills:

List any new interests, skills, training, graduations or activities since last summer.
Skills: *
Personal Information

The following information will be kept confidential.
Do you use illegal drugs? *

Yes No
Have you ever been convicted of a criminal offense? *

Yes No
Have you ever been charged with child neglect or abuse? *

Yes No
Other than the above, is there any fact or circumstance involving you or your background that would call into question your being entrusted with the supervision, guidance, and care of young people? *

Yes No
If so please explain:
Were you a victim of abuse or molestation while a minor? *

Yes No
If so please explain:
If you would perfer not to explain, we ask that you be willing to discuss your answer in confidence with the Camp Director. Answering yes does not necessarily disqualify you from a staff position.
Known Allergies (Including Food)
Testimony

Please fill us in since the last summer you were here.
Describe your present relationship to Jesus Christ, to your church and to other Christians and what interests you in continuing to serve in the Christian camping ministry at Camp Luz: *
Affirmation: The information contained in this application is correct to the best of my knowledge. I authorize any references or churches listed in this application to give you any information (including opinions) that they may have regarding my character and fitness for children and youth work. In consideration of the receipt and evaluation of this application by Camp Luz, I hereby release any individual, church, youth organization, charity, employer, reference, or any other person or organization, including record custodians, both collectively and individually, from any and all liability for damages of whatever kind or nature which may at any time result to me, my heirs, or family, on account of compliance or any attempts to comply, with this authorization. I waive the right that I may have to inspect any information provided about me by any person or organization identified by me in this application. *

Please Check
Signed: *
Full Name
Date *

Month Day Year
Recommendations

Can you recommend Christ-centered persons we should contact about serving Camp Luz on summer staff?
1. Name

First Name Last Name
Phone Number

Area Code Phone Number
E-mail
2. Name

First Name Last Name
Phone Number

Area Code Phone Number
E-mail
Should be Empty:

Returning Staff Application 2022

Staff Positions

Staff Training

Summer Camp

Personal Skills:

Personal Information

Testimony

Recommendations