Houghton RFKC Reapplication

Houghton RFKC Reapplication

Reapplication Form for Returning Counselors and Staff
Please Note:

If you are committed to returning to camp, please complete this form by mid-January. Please do not submit this form unless you are committed to serving next summer.
Background Check:

In order to maintain compliance with RFK, Inc.’s requirements, you may be asked at a later date to complete a criminal background check. Any costs associated with such a check will be covered by Houghton RFKC.
Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell Phone
Please enter a valid phone number.
Home Phone
Please enter a valid phone number.
T-shirt Size*

SMLXLOther
Email*
example@example.com

Are you a Houghton College Student?*

YesNo
What is your CPO?
Phone # to reach you after the spring semester (if different from above):
Please enter a valid phone number.

Medical Information

it is not necessary to list meds on this form. Rather, give list of your meds to our Camp Nurse at camp.
Do you have any current medical problems?*

YesNo
Please explain*
Do you take any medications?*

YesNo

Immunization Information

If you submitted the following information last year and it has not changed, you may leave this section blank. Otherwise, please respond.
Have you been inoculated for Measles and Mumps? (If you were born after 1956, inoculation is required)

YesNo
Have you had a tetanus shot within the past 10 years?

YesNo
Date of last tetanus? (You do not need to update your tetanus. We simply need to know, in case of emergency, if your immunization is current or not.)

Emergency Contact
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
What is this person's relationship to you?*

Personal Profile
Royal Family Kids is a Christian organization, and our camp maintains essential principles of Christianity such as the following: belief in God, Jesus, and the Holy Spirit; the need for forgiveness of sin and living in accordance with Biblical principles; and the responsibility to disciple others through word and deed. Presumably we have considered you to be a Christian role model for children—or we would not have accepted you to work at RFKC in the first place. Do you hold these essential principles as your own?*

YesNo
Please explain*
Since July, 2022, have you been arrested for a criminal offense?*

YesNo
Please explain*
Since July, 2021, have you taken illegal drugs?*

YesNo
Please explain*
Does your lifestyle—including your online presence (Instagram, Facebook, Twitter, Snapchat, etc.)—reflect values consistent with those of Royal Family Kids Camp?*

YesNo
Please provide more detail*

Are you applying to be a counselor?*

YesNo
What ages of children do you prefer to work with at camp this summer?
Do you have any special requests concerning specific campers and/or buddy counselor?

Are you interested in modifying your role with RFKC this summer?*

YesNo
Please explain*

Child Abuse Policy
I understand that for the church to carry on a RFK Camp, it has had to agree to abide by certain policies and parameters established by RFK, including 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 the church is 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 the church’s RFK Camp 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.
Do you agree with the Child Abuse Policy Stated above?*

YesNo

Background Check
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.
Do you agree to submit to a background check?*

YesNo

Certification
I hereby certify that all of the information provided by me in this Application (or in any other accompanying or required documents) 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.
Do you certify the accuracy of the information you have submitted as stated above?*

YesNo

Hold Harmless Agreement
In consideration of the receipt and evaluation of this Application by the sponsoring Church, 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 to you 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 RFK, the sponsoring church, RFK Camp Leadership, and any other person to whom the release above applies, harmless from any damages, specifically including attorney fees and court costs, created by or relating to my unwarranted attempt to collect damages for providing information described above or any other unwarranted action by me in connection with this Application. 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.

In addition, I hereby release, and agree that I, my successors, assignees, heirs, guardians and legal representatives will not make any claims or take any legal actions against, RFK or any of its affiliated organizations, or its officers, directors, employees, agents, or volunteers (“Released Parties”), for my injury, death, damage or loss, however caused, arising from or in connection with my participation in RFK activities, with the exception of my injury, death, damage or loss as the direct result of illegal or grossly negligent acts by RFK, and I will hold the Released Parties harmless from any costs or loss, including attorney fees and court costs, arising from or in connection with my activities in violation of these provisions.
Do you agree with the Hold Harmless Agreement stated above?*

YesNo

Final Confirmation
I understand that submission of an application does not guarantee me acceptance as a volunteer. I further understand that should the church extend an offer to me as a volunteer, it is for no specific duration and may be revoked by either the sponsoring church, or me at any time, with or without cause.

I understand that none of the documents, policies, procedures, actions, statements of RFK, the sponsoring church, the RFK Leadership or their representatives and agents used during the volunteer application process is deemed an offer for a contract or in fact a contract, real or implied. If accepted as a volunteer, I agree to conform to the rules, regulations, policies, and procedures while serving as a volunteer, and understand that such compliance is a condition of remaining a volunteer.

All Royal Family KIDS Camps are operated as a ministry of a local Sponsoring Church or in conjunction with a local non-profit organization. As such, all volunteers will fall under the authority of the Camp Leadership as trained by the RFK National Office and under the authority and beliefs of the Sponsoring Church. The Sponsoring Church may or may not require membership or attendance of their church, but all volunteers need to understand that church leadership has authority over the operations and expectations of the RFK Camp and the churches beliefs will inevitably be evident in the selection process and operation of the RFK Camp as a ministry of their church.

I have carefully read the above Application and this Acknowledgement and Release and know and understand its contents; I also know the above is legally binding on me.

I submit this Application and Release of my own free will.
Should be Empty:

Houghton RFKC Reapplication

Please Note:

Background Check:

Medical Information

Immunization Information

Emergency Contact

Personal Profile

Child Abuse Policy

Background Check

Certification

Hold Harmless Agreement

Final Confirmation