Love City USA Chaperone Application

Love City USA Chaperone Application

If you have a camper attending or would
NLC Love City Community Development Corporation, INC. (Love City USA)

Love City USA Summer Camp Chaperones Is A Subsidiary of Volunteers of New Light Church
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Are you a member of New Light Church?*
Have you ever volunteered for LOVE City or Spiritual Encounter?*
Have you ever been convicted of a felony*
Camp Chaperone Preferences(Please select your top three)*

Food ServicesGame LeaderLifeguardsBeach Front Lake AssistantMaintenance AssistantMedia AssistantMedical AssistantRegistrar's AssistantRegistered NurseSecurity AssistantSpecial Guest AssistantStage AssistantQuick Stop Shop AssistantPeacekeeperDormitory AssistantSkating AssistantBasketball AssistantPaintball AssistantArcade AssistantActivities Assistant
Camp Session Availability *

June 13th-16thJune 20th-23rdJune 27th-30th
Monday Availability

Monday (24 hour shift) (full day)Monday Half Day (1 PM - 6:30 PM)Monday PM (6 PM - 6:30 AM) Overnight
Tuesday Availability

Tuesday(24 hour shift) (full day)Tuesday AM (6 AM - 6:30 PM)Tuesday PM (6 PM - 6:30 AM) Overnight
Wednesday Availability

Wednesday (24 hour shift) (full day)Wednesday AM (6 AM - 6:30 PM)Wednesday PM (6 PM - 6:30 AM) Overnight
Thursday Availability

Thursday Shift 1 (7:30 am-3:30 pm)
How did you hear about chaperoning at Love City USA Camp? (Check all that apply)*

New Light ChurchAIM ChurchRadioTelevisionFriendFamilySpiritual Encounter AlumniOther
If other, please list below how you heard about chaperoning.
Please note that a more extensive background check is part of the chaperone decision-making process, and you will need to sign any necessary disclosure and release forms as part of the chaperone selection process to complete a background check.
ACKNOWLEDGEMENT: I understand that my service at the Love City USA Camp is in a volunteer capacity. I also declare by my signature below that the statements and information I have provided on this form are true and accurate to the best of my knowledge and belief. I understand that any intentional omission or misstatement of fact on this application will be sufficient cause for dismissal of service.
Please Print Full Name Below*

Clear
Please Sign Below*

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Love City USA Chaperone Application

NLC Love City Community Development Corporation, INC. (Love City USA)

Please note that a more extensive background check is part of the chaperone decision-making process, and you will need to sign any necessary disclosure and release forms as part of the chaperone selection process to complete a background check.