2024 SNEMN SUMMER CAMP LEADER APPLICATION

2024 SNEMN Camp Leader Application

REGISTRATION: All applications are due by May 31, 2024.

There is no longer a $10.00 Registration Fee required for all Staff/Leader Applications. Background checks are still required for all camp leaders/volunteers. Please make your camp coordinator aware that you have applied to be a leader at camp.

Please take notice: Staff applications are accepted on an as needed basis. The SNE Ministry Network Camp Director reserves the right to refuse an application based on lack of need or failure to meet specific criteria.

LOCATION: All Camps will be held at Rumney Bible Conference in Rumney, NH. The physical address is 31 Gilford Ave. Rumney, NH 03266. All persons are admitted without regard to race, color, national origin, sex, or handicap.

ALL-STAFF TRAINING: All staff/Leaders/LITs must attend the All-Staff Training held in person. The Mandatory training date will take place the Sunday before each summer camp. More information to come upon completing your application. TRAINING IS MANDATORY.

MEDICAL POLICY – A RN working with standing orders from a local physician will be on the grounds at all times. Our camps are covered by a limited accident and liability insurance.

EMERGENCIES, VISITORS & PHONES: In case of an emergency, please call the following number for the Rumney Bible Conference – (603) 786-9504. The can be reached by email at director@rumneybibleconference.org. Under normal circumstances, you should not be visited or contacted by phone while at camp.

OPENING & CLOSING OF CAMP: All Staff/Leaders/LITs must check-in upon arrival. It is imperative that you arrive at the campground at 10am on the day of camp before students attive. We ask that all staff and LITs remain on campus until dismissed by the Camp Director.

CABINS & ROOM ASSIGNMENTS: Upon arrival, you will be assigned a team name and bunk area including beds for your campers. Housing will be assigned by Gender at Birth

WHAT TO BRING: Bible, flashlight, towels/washcloths, appropriate clothing camera, bedding, pillow, notebook/pen, jacket, rainwear, sneakers, personal care articles, sunscreen, non-aerosol bug repellent, sleepwear, swimwear, umbrella, alarm clock.

WHAT TO FORGET: Weapons, knives, TV’s, improper magazines or books, drugs, fireworks, firearms, cigarettes/tobacco. If these items are found, they will be confiscated.

DRESS CODE: We take pride in the appearance of our campers and staff. Your dress sets the tone and attitude of your campers. All campers and leaders are expected to dress and groom his or herself neatly. Inappropriate clothing includes tube tops, strapless dresses or tops, spaghetti strap tops, super short shorts/skorts or mini skirts, clothing that advertises beer or cigarettes. Swim Suits for ladies are to be one piece and boxer style for men (please, no Speedo type suits). For safety reasons, shoes, sandals or sneakers must be worn at all times. SNE Ministry Network reserves the right to ask campers/leaders/staff to change into more appropriate clothing.

RULES & GUIDELINES: Specific rules will be given at all staff training and are available in the staff manual. Any infraction of the rules and guidelines will result in expulsion from the camp at your expense.

BACKGROUND CHECK: A criminal background check will be run on each Staff/Leader. Your social security number and date of birth is required for this purpose.

SPECIAL NOTES: There is no longer a $10.00 fee for working as a staff member at camp. L.I.T.'s are required to pay $165. All other leader costs are paid through the camp budget. The online payment form can be found at www.snemn.com/summer-camp.

Adult camp leaders are no longer required to have a physical or shot records to serve at our Camps.

CONTACT US:

Chris Hurtado – Chris@snemn.com

Director of Ministries and Resourcing

Southern NE Ministry Network

307 Sturbridge Rd, Charlton, MA 01507

Phone: 508 -248-3711 ext. 729, Fax: (508) 506 - 5897

Name:*

First NameLast Name

Camp Week(s) You Will Attend.*

Kid's Camp: July 22-26, 2024JR. High Camp: July 1-5, 2024

Address:*

Street Address

Street Address Line 2

CityState

Zip Code

Phone Number

Please enter a valid phone number.

Date of Birth:*

Date

Age:*

Gender at Birth:*

Email:*

example@example.com

Marital Status:*

High School Completed:*

College Completed:*

Camp Staff Experience:*

Church Name and Location*

Emergency Contact:*

First NameLast Name

Emergency Contact's Phone:*

Please enter a valid phone number.

Church Camp Coordinators Name:

Church Camp Coordinator's Email:*

example@example.com

Activity Participation

Activities, including but not limited to:

Swimming (pool and lake), Hiking/Outdoor Activities (In which participants could possibly get bites from insects, ticks, mosquitos, spiders, and/or snakes, etc...), Jumping, Throwing, Field Games, Canoeing (life jackets required for all participants), Water Inflatables, Outdoor Sports, Indoor Game Room, Walking/Running, Food Challenges, Recreational games (relay race styles, tug-of-war, etc., which may involve water and mud). Extra Activities include: Tubing, Paintball.

Are you willing to participate in camp activities?*

YesNo

Can you swim?*

YesNo

Date and Location of Activities:

Rumney Bible Conference, 31 Gilford Ave. Rumney, NH

(1) Sr. High Camp: June 24-28, 2024

(2) Jr. High Camp: July 1-5, 2024

(3) Kids Camp: July 22-26, 2024

Family Doctor:*

Physician's Phone:*

Please enter a valid phone number.

Insurance Company:*

Policy/Group #:*

Are you presently being treated for injury/sickness or taking any form of medication? If yes, explain.*

Are there any special medical instructions?*

Any medication, foods or environmental conditions that you are allergic to, and expected reactions?*

Any physical handicaps, disorders and diseases?*

Are there any mobility limitations or activities you would not like to participate in? If Yes, explain.*

List all medications to be administered at Camp:*

History of:*

All medications must be in original container and clearly labeled: patient’s name, physician’s name, name of medication, prescription number, date prescribed, instructions. DO NOT SEND OVER-THE-COUNTER Medications (i.e.Tylenol or Advil) as the nurse has these on hand. Exception: Claritin with Doctor’s note and instructions. The following over the counter medications will be available in brand name or generic name and age appropriate dosing and form, i.e. liquid or tablets and will be given according to label dosing guidelines: Acetominophen (Tylenol), Ibuprophen (Advil), Benadryl, Sudafed, Mylanta, Tums, Immodium, Auri-Dri, Neosporin, Calamine Lotion, Hydrocortisone Cream, Robitussin, Cough Drops, and any other over the counter medication deemed necessary. If your child takes another OTC medication on a regular basis, please send that with a doctor’s note for administration at camp.

PERSONAL HISTORY

The personal history information must be completed by all applicants for any position (volunteer or compensated) involving supervision or custody of minors in any scheduled program or activity at the SNE Ministry Network Summer Camps. It is being used to help provide a safe and secure environment for those children and youth who participate in their schedule activities at the Summer Camp.

Do you use tobacco?*

YesNo

Do you drink alcoholic beverages?*

YesNo

Do you use nonprescription drugs?*

YesNo

Have you ever been convicted of, pled guilty or no contest to a crime other than a minor traffic violation?*

YesNo

If your answer was Yes in the previous question, please explain, including the name of the crime(s), the date and disposition of the case(s):

Are you presently facing charges for any criminal offense?*

YesNo

If your answer was Yes in the previous question, please explain:

Have you ever been accused of or charged with any offense involving children?*

YesNo

If your answer was Yes in the previous question, please explain, including disposition or current status of the charge:

Name of Church of which you are a member:*

Church City and State:*

Pastor's Name:*

How long have you been saved?*

Do you believe in the Baptism of the Holy Spirit?*

YesNo

List all names and addresses of other churches you have attended regularly within the last five years.

List all previous church work involving youth (list type of work performed and the dates of service).

List all previous non-church work involving youth (listing each organization’s name, type of work performed and the dates of service).

All Ministry Team members must register upon arrival at the campsite. It is imperative that you arrive at the campground 2 hours before students arrive. We ask that all staff and LITs remain on campus until dismissed by the Camp Director.

The information given in this application is correct, to the best of my knowledge.

Sign Below. *

Date Signed*

Date

Printed Name

First NameLast Name

Southern New England Ministry Network

Leader Authorization Release/Disciplinary Clause

I understand that participation in camp activities with the Southern New England Ministry Network Camp brings with it a certain amount of risk. I acknowledge and accept the risks of physical injury associated with participation in the activities (including extra activities of paintball and tubing) described in the camp registration. Should there be any activity for which I wish to abstain from, I will notify the Southern New England Ministry Network Camp in writing at the time of registration. In consideration of the risks involved, I understand that the Southern New England Ministry Network Camp and Rumney Bible Conference in Runney, NH have taken the necessary precautions to ensure my safety and well being. I hereby release and waive any and all claims against the Southern New England Ministry Network Camp, Rumney Bible Conference in Runney, NH and its staffs arising from my participation in the Southern New England Ministry Network Camp. I also release and waive all personal financial responsibility for any injury or loss sustained during the activities and hold both the Southern New England Ministry Network and Rumney Bible Conference in Runney, NH harmless for such injury or loss arising directly or indirectly from said activities.

The health history included in this application is correct as far as I know and I can engage in all prescribed activities, except as noted by the physician and me. IN CASE OF EMERGENCY, I hereby give permission to the physician urgent care, or emergency room to secure proper treatment, including hospitalization, anesthesia, surgery, or injections of medication for me. I hereby give my consent, in the event that all reasonable attempts to contact my emergency contact have been unsuccessful, for the administration of any treatment deemed necessary by the appropriate licensed physician, nurse, dentist or emergency personnel. I also give permission for the Camp Nurse to administer over the counter medication to me as deemed necessary according to dosing guidelines and attend to any other necessary healthcare means.

I also hereby understand that if I refuse to adhere to the camp policies listed herein, I may be dismissed to go home immediately. I also hereby give permission to the camp staff to inspect the contents of any or all of my personal belongings, and to withhold and/or dispose of any improper or illegal contents.

If a dispute over this agreement or any claim for damages arises, the participant (or parent/legal guardian) agrees to resolve the matter through a mutually acceptable arbitration process.

Leader Signature:*

Date Signed:*

Date

Leader Name: *

First NameLast Name

Witness Signature:*

Date Signed:*

Date

Witness Name: *

First NameLast Name

Southern New England Ministry Network

Photo & Video Release Form

I hereby grant the Southern New England Ministry Network permission to the rights of my image, likeness and sound of my voice as recorded on audio or video without payment or any other consideration. I understand that my image may be edited, copied, exhibited, published or distributed and waive the right to inspect or approve the finished product wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of my image or recording.

I agree that the Southern New England Ministry Network may use such images, video and/or audio of me with or without my name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and web content.
There is no time limit on the validity of this release nor is there any geographic limitation on where these materials may be distributed.
By signing this form, I acknowledge that I have completely read and fully understand the above release and agree to bound thereby. I hereby release, defend, hold harmless and indemnify the Southern New England Ministry Network from any and all claims for utilizing this material.

Please note that signing this form is not required and does not disqualify anyone from attending our camps.

Full Name:

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState

Zip Code

Phone Number*

Please enter a valid phone number.

Email

example@example.com

T-SHIRT SIZE

Signature

Upload Completed Medical Forms Here

2024 SNEMN CAMP LEADER APPLICATION

General Information

Medical Information

PERSONAL HISTORY

CHURCH HISTORY AND PRIOR YOUTH WORK

Southern New England Ministry Network

Leader Authorization Release/Disciplinary Clause

Photo & Video Release Form