Returning Volunteer (Camp) Application 2020

(FTC Sandy GSLC RFKC)

Camp Dates: July 24- July 29, 2022

All information is held strictly confidential. This form must be completely filled out. The information is vital to your acceptance and possible placement as a volunteer
During which recent years have your volunteered at RFKC-GSLC Camp? Select all that apply:*

202120202019This is my first time to serve at a Royal Family KIDS Camp or I have volunteered only prior to 2019. -Please, do not use this form and complete a New Volunteer (Camp) Application.I volunteered at another RFK Camp. -Awesome: Please, do not use this form and complete a New Volunteer (Camp) Application.I am a returning Staff or Mentor (old Counselor)
Full Legal Name:*

First Name Middle Name Last Name
Birth date:*

Month Day Year
Driver's License or other state issued ID Number:*
Issuing State: *
Last four digits of your Social Security Number*
Last four of your SSN
Your Full Social Security number will be used to obtain the criminal background check from a third party. A photo I.D. (preferably Drivers license, Passport etc.) will be required to be shown at the interview to verify that your photo, name and SSN match the name on this application and background check
Please upload a current photo of yourself. Your opportunity for a selfie!
File types: jpg, jpeg, png, gif
Gender:*

MaleFemale
Current Age:*
Marital Status:*
Address:*

Street Address

Street Address Line 2

City State

Zip Code
How long have you lived in Utah? Years*
E-mail:

Confirmation Email
Phone Number: Best one to contact you:*

Area Code Phone Number
Occupation:*
Name of Employer:*
Number of Years at Current Employer:*
Emergency Contact:*
Relationship: *
Phone (Emergency Contact):*
Covid related questions (check all that apply)*

Received Covid vaccinePlanning on getting Covid vaccineI had Covid and recoveredI am NOT getting a Covid vaccination
You will received a name tag to wear at Camp. What would you like your name tag to be (if other than your first name)?
Choose T-Shirt Size. Use the chart below to select the best size for you.
T-shirt Gender: (the styles and colors are often different with v-neck for women):*

MaleFemale
Select T-Shirt Size

Adult SmallAdult MediumAdult LargeAdult X-LargeAdult 2X-LargeAdult 3X-Large
Your Role at Camp
Will you be able to attend mandatory, in person, volunteer training on Saturday, June 11, at Good Shepherd Lutheran Church, 9am-4pm (lunch will be provided):*

YesNo. I understand that I need 8 hours of training. If I can not make it in person training I will make up by July 20. Contact me with the details.
What have been your roles during recent years at Camp? *
What roles would you prefer during the 2022 Camp? *
What roles would you prefer NOT to volunteer for? *
Why do you feel called to participate in the 2022 Camp? *
If you wish to be a camp mentor. Please, describe why you wish to be a mentor (old counselor) for kids in foster care?
What is your availability? *

The entire Camp Week: July 24- July 29 (Required for Mentors)All day: July 25 - July 29 (9am-5pm)All Afternoons: July 25 - July 29 (1pm-4pm)All evenings: July 25-July 29 (7pm-10pm) Dream Team (will have van for carpooling)I'm not sure but I will know by June 26I can help at Good Shepherd only with check-in on July 25 and check-out midday Friday July 29.If you can not select one of the previous options, we may not be able to have you volunteer at Camp. Consider helping with set up (Sunday afternoon, July 24); Birthday Party (Thursday morning); or Welcome Home Dinner (Fri afternoon/evening). Send email to UtahRoyalKids@gmail.com for more info on these options.
Do you have a current certification/license in the following?

CPRFirst AidLife GuardNurseEMTCounseling or Therapy
Do you have previous background or training in working with children who have been abused or neglected?*

YesNo
Were you a victim of abuse, neglect, or abandonment as a minor?*

YesNoYes, but I would prefer to discuss this in person
If yes, please clarify*
Personal Profile
Have you committed your life to Jesus Christ?*

YesNo
What church do you presently attend?*
For how long?*
Pastor's Name*
Please describe why you wish to return as a volunteer for Royal Family KIDS:*
Have you worked with or associated with abused, neglected or abandoned children this past year?*

YesNo
If Yes, please describe in what way:*
This year I would prefer to work with campers in this group?*

7-9 years old9-11 years oldNo preference
How would you like to serve at Camp (Select all that apply)*

Any positionMentor (old counselor)ActivitiesGrandparentNurseDrama/Bible teachingDream Team (Bedtime reading)
Do you feel you could lead a 15-minute devotion with your campers with materials we provide?*

NoYes
List three to five strengths you have in working with children: Please be specific*
List three to five weaknesses you have in working with children: Please be specific*

Following Rules: How well do you follow rules and respond to authority*

	1	2	3	4	5

1 is Poorly, 5 is Very Well

Please, let us know how Royal Family KIDS has impacted your life:*
MEDICAL CONCERNS

Camp can be physically tiring, even exhausting. The facility or activities may require volunteers to manage uneven terrain, be at a high altitude, require hiking, climbing, running, swimming, lifting, stairs, and other strenuous activities depending on the volunteer position. Your medical condition (physical fitness, recent or chronic injuries, allergies, physical or emotional limitations, etc.) and even the medications you take may be affected by the activities, the altitude, the foods served, the emotional challenges with the kids, or the sleeping conditions. (Note: Volunteers who stay in the sleeping quarters with the children are not allowed to have medications in those quarters. Medications must be kept in other secure locations as designated by Camp Leadership.)
Do you have any medical, emotional, or mental health conditions?*

NoYes
If Yes, please describe those conditions(s);*
Are you taking any prescription medications?*

YesNo
If Yes, please list all medication, reason and any side effects:*
For example: 1) Name of medication, reason, side effect.
Have you had any serious medical conditions, injuries, or surgeries during the last three years? *

YesNo
If Yes, please identify:*
Do you have any physical challenges or conditions prevent you from performing any type of activity?*

NoYes
If Yes, please list challenges or conditions:*
Are there any other medical related issues we should be aware of?*

NoYes
If Yes, please, identify those medical issues.*
Criminal Background

If your records have been expunged pursuant to applicable law, you are not required to answer yes to the following questions. If you are unsure whether to answer yes, we strongly suggest that you answer yes and fully disclose all incidents to avoid any future risk of embarrassment upon disclosure.
1) Have you ever been convicted of or pleaded guilty to any crimes (including crimes of record which have been expunged and pleas of 'no contest'), including municipal, state and federal?*

NoYes
2) Have you ever been placed on probation, received a Suspended Execution, Suspended Sentence or Suspended Imposition of Sentence for any offense involving a minor child (a child under 18), or been placed on ANY local, state, or federal sexual registry?*

NoYes
3) Have you ever been sued in a civil court of law where the allegations in the suit involved illegal, inappropriate, or sexual conduct or contact with a minor child?*

NoYes
4) Have you ever been subject to any court order involving any sexual, physical or verbal abuse including but not limited to any domestic violence or civil harassment injunction or protective order?*

NoYes
5) Have you ever resigned, been terminated or been asked to resign from a position, whether paid or as a volunteer, due to a complaint(s) of sexual, physical or verbal abuse of minors?*

NoYes
If yes to any of the above, please explain. You may also choose to ask to discuss your answers privately with us:*
REPRESENTATIONS AND RELEASE

I acknowledge that Royal Family Kids Camp adminstered by Sandy GSLC chapter of For The Children is a faith based ministry and I agree with the basic tenets of Christianity believing in one God the Father Almighty, Maker of heaven and earth, And in one Lord Jesus Christ, His only-begotten Son. I understand that I am not to proselytize or denigrate other faith beliefs. I understand that as a person having direct contact with Utah Foster Children I must undergo a mandatory Criminal Background Investigation and I give my permission for RFKC-Sandy GSLC to conduct a confidential Background Investigation for the purpose of determining my fitness to serve as a RFKC-Sandy GSLC volunteer. I understand that the use of alcohol and drugs (excepting prescribed medication) is prohibited at Camp. I understand that smoking cigarettes is prohibited in the presence of children or in any area of Camp accessible to children. I understand that I am expected to follow the Camp rules described in the training manual and during training.

I understand that RFKC-Sandy GSLC and FTC maintain strict policies against any form of child abuse, and that violation of these policies may be cause for dismissal. Child abuse is punishable by law, and RFKC-Sandy GSLC and FTC are bound by law to report allegations of abuse or any inappropriate sexual contact to the proper authorities. ALL reporting is kept confidential, by law. All volunteers must commit to immediately report any behavior that seems suspicious, questionable, abusive or inappropriate between: child-to-child, staff-to-child, and staff-to-staff.

If YOU are struggling with a sexual attraction to children, please opt out of service in RFK or any other child-serving organization, and seek help. One option is: “Hope for the Heart” at (800) 488-HOPE (4673) or www.hopefortheheart.org.

I understand that I will be required to submit to a background check as a condition of acceptance as a volunteer, and that unsatisfactory results, refusal to cooperate, or any attempt to affect the results of these background checks will result in me being removed as a volunteer or volunteer applicant.

I hereby certify that all of the information provided by me in this Application is correct, accurate and complete to the best of my knowledge. I understand that the falsification, misrepresentation or omission of any facts in these documents may (or will) be cause for the denial of acceptance as a volunteer, or immediate removal as a volunteer, regardless of the timing or circumstances of discovery.

In consideration of the receipt and evaluation of this Application by RFKC-Sandy GSLC, I hereby authorize you to contact any references, churches, youth groups, schools attended, former and present employers, charities, courts, and any other person, agency, or organization that may have information about me, and for them to provide such information (including opinions) that they may have regarding my character and fitness for working with children; I hereby release any such references, churches, youth groups, schools attended, former and present employers, charities, courts, and any other person, agency or organization who may have provided information about me, 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 also agree to hold FTC, Utah Royal Kids, Good Shepherd Lutheran Church, and RFKC-Sandy GSLC Camp Leadership harmless from any damages created by my unwarranted attempt to collect damages for providing information described above. I waive any right that I may have to inspect any information provided about me or by any person or organization identified by me in the Application process.

I understand that submission of an application does not guarantee me acceptance as a volunteer. I further understand that should the RFKC-Sandy GSLC Leadership extend an offer to me as a volunteer, it is for no specific duration and may be revoked by the RFK Camp Leadership or me at any time, with or without cause.

I understand that none of the documents, policies, procedures, actions, statements of FTC, URK, Good Shepherd Lutheran Church, the RFKC-Sandy GSLC Leadership or their representatives and agents used during the volunteer application process is deemed a contract, real or implied. If accepted as a volunteer, I agree to conform to the rules, regulations, policies, and procedures of FTC and RFKC-Sandy GSLC while serving as a volunteer, and understand that such compliance is a condition of remaining a volunteer.

I understand the RFKC is a faith based organization, but is not affiliated with any specific denomination. Campers may or may not have any denomination or church affiliation. All Participants are not to proselytize or bring up any discussion related to doctrine or beliefs unless brought up by the camper.
Do you have any comments or feedback for us?
By my eSignature verification below, I verity that I understand that electronic signatures are legally binding and have the same meaning as handwriteen signatures. I certify that I confirm that this electronic signature is to be the legally binding equivalent of my handwritten signature and that the data on this form is accurate to the best of my knowledge.
Print Full Name*
eSignature*
Thank you for your interest in being a part of the RFKC-Sandy GSLC Team!
Should be Empty:

Your Role at Camp

Personal Profile

MEDICAL CONCERNS

Criminal Background

Thank you for your interest in being a part of the RFKC-Sandy GSLC Team!