TEEN REACH ADVENTURE CAMP
Lakeland, FL
RETURN STAFF APPLICATION
If you are applying for the FIRST TIME to T.R.A.C. Lakeland, please visit https://form.jotform.com/242306591869062
2026 T.R.A.C. Staff Dates
Staff Training - TBA (Childcare included.)
Boys Camp - January 16-19, 2025
Girls Camp - February 6-9, 2025
READ BEFORE COMPLETING THE APPLICATION
You will need the names and contact information of a ministry and a personal reference (excluding The King's Church pastors and staff) AND a recent photo to successfully complete this application.
Name
First Name
Last Name
Street
City
State
Zip Code
Cell Phone
E -MAIL
Birth Date
/
Month
/
Day
Year
Date Picker Icon
Sex
Male
Female
Marital Status
Living Situation
Emergency Contact Name
Emergency Contact Phone Number
Please upload a current high resolution picture of yourself. Selfies welcome!
Browse Files
Drag and drop files here
Choose a file
Cancel
of
REFERENCES (Please do not list T.R.A.C. leadership, The King's Church pastors, or Amy Hornbuckle as a ministry reference.)
Name
Phone Number
Email Address
Professional
Ministry
T-Shirt Size
Adult Small
Adult Medium
Adult Large
Adult X-Large
Adult XX-Large
Adult XXX-Large
Women’s style/cut
Do you have a certification in the following?
CPR
First Aid
Lifeguard
Nurse
EMT
Why do you wish to continue volunteering at T.R.A.C.?
Do you have any dietary restrictions?
No
Yes
If yes, please list:
Do you have any moderate to severe medical conditions?
No
Yes
If yes, please explain:
Do you take any medications?
No
Yes
If yes, please list them below:
Medication
Reason
Possible Side Effects
Medication 1
Medication 2
Medication 3
Medication 4
Medication 5
Medication 6
Medication 7
Medication 8
Medication 9
Medication 10
Has anything significant changed in your life in the past year, personally or professionally?
No
Yes
If yes, please explain:
In the past year, have there been any changes in your legal record?
No
Yes
In the past year, have you been accused or convicted of any sexual misconduct?
No
Yes
In the past year, have you ever taken drugs other than prescriptions?
No
Yes
If you answered "yes" to the above three questions, please explain:
How has God been growing you over the past year?
I have read, agree with, and will comply with the Teen Reach Statement of Faith, Volunteer Standards, and Position Statement. (Read at https://shorturl.at/MzSMj)
Yes
No
(Check all that apply) I am interested in volunteering at:
Boys Camp - January 16-19, 2025
Girls Camp - February 6-9, 2025
(Check all that apply) I am interest the role(s) of:
Camp Counselor
Photographer
Extended Family (Aunt, Uncle, Grandma, Grandpa)
Challenge Course Facilitator
CrossTalk Teacher
Musician
Arts/Crafts
Other
I certify, under penalty of perjury, that my signature below signifies this information is true and correct to the best of my knowledge. I give permission for T.R.A.C. to request background checks for me to become a staff member/camp counselor for Teen Reach Adventure Camp.
Name
Signature
Date
/
Month
/
Day
Year
Date Picker Icon
Save
Submit
Should be Empty: