2024 Volunteer Application

Volunteer Information

Name*

First NameLast NameName For Name Tag

Birth Date*

MonthDayYear

Gender*

MaleFemale

Address*

Street Address

Street Address Line 2

CityState

Zip Code

How long have you lived in your state?*

Email*

Phone Number*

Area CodePhone Number

Marital Status*

Work

Driver's License #*

Please upload or take a pic of your license

*Use Camera to take Photo of License

*Press Upload button after selecting Image

Camp Information

Are you a new volunteer or a returning volunteer*

New VolunteerReturning Volunteer

How many years have you volunteered at Camp (not including this year)?

Volunteer preference (We cannot guarantee that you will get your preference)*

Camper BuddyStaffEither

Preferred Staff Roles (give 2 or 3 suggestions)*

T-Shirt Size (Adult)*

Do you want to order additional T-Shirts?*

No, I will use last year's T-ShirtsYes, I would like to order additional T-Shirts ($15 each)

T-Shirt Size*

T-Shirt Color*

Have you worked with or associated with underprivileged, abused, abandoned, or neglected children?

Do you have certification in the following:

Emergency Information

Emergency Contact's Name*

First NameLast Name

Relationship*

Emergency Contact Phone Number*

Area CodePhone Number

Do you take any medications?*

Do you have any physical or medical conditions that could affect your participation in any type of activity?*

In case of emergency, I hereby give permission to the physician selected by the Camp Director or his agent to hospitalize or secure proper treatment for the undersigned.

Insurance Company:

Policy Number:

Education:

High School*

Date of Graduation*

College / Major

Date of Graduation

Personal References: (Not relatives)

1. Personal Reference*

First NameLast Name

1. Personal Reference Phone*

Area CodePhone Number

2. Personal Reference*

First NameLast Name

2. Personal Reference Phone*

Area CodePhone Number

3. Personal Reference*

First NameLast Name

3. Personal Reference Phone*

Area CodePhone Number

Personal Profile:

How did you hear about Champ Camp?*

Have you committed your life to Jesus Christ?*

noyes

Where and when?

What church do you presently attend?*

How long?*

Pastor's Name

First NameLast Name

Church Phone Number

Area CodePhone Number

Please describe your spiritual growth since you last volunteered at Champ Camp

Do you have any previous experience working with children?*

Do you have previous training or background in dealing with abused children?*

noyes

If yes, in what way?

Please describe why you wish to volunteer to work with abused children?*

Do you feel you could lead a 15-minute devotion with your campers with material we provide?*

noyes

List two strengths you have in working with children:*

List two weaknesses you have in working with children:*

I would prefer my camper's age to be:*

Have you ever been arrested, convicted, or plead guilty for a criminal offense?*

noyes

Have you been arrested, convicted, or plead guilty for a criminal offense since you last volunteered at Champ Camp?*

noyes

Have you ever been accused, convicted, or plead guilty of any sexual misconduct?*

noyes

Have you been accused, convicted, or plead guilty of any sexual misconduct since you last volunteered at Champ Camp?*

noyes

Do you currently use:*

TobaccoAlcoholDrugsNone

Have you ever taken drugs other than prescription drugs?*

noyes

Have you taken drugs other than prescription drugs since you last volunteered at Champ Camp?*

noyes

If you answered "yes" to any of the above, please explain:

Applicant's Statement

The information contained in this application is correct to he best of my knowledge. I authorize any references listed in this application to give you any information that they may have regarding my character and fitness to volunteer at Champ Life Kids Camp (Champ Camp).

In that respect, I release Champ Life and its administrators, employees, or assigns from any liability for damages, which may occur as a result of my services as a camp volunteer. I accept full responsibility for my actions as a camp volunteer.

I understand this is not an application for employment. My services are strictly voluntary and at the will of Champ Life. No compensation or other benefits have been offered to me as consideration for my services.

I also understand that a criminal background check will be requested, as authorized by State law.

I waive any right that I may have to inspect any information provided about me by the my State or any person or organization identified by me in this application.

Finally, I acknowledge that Champ Life is a charitable, non-profit organization. Any use of camp programs, communication materials, or sponsor lists are forbidden without the expressed written approval of Champ Life.

Confirmation BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

Signature*