Returning Camp Staff Application
Chapter #354 Camp Dates: July 27th- August 1st
Mandatory Staff Training
Saturday, June 28th 8:00am-3:00pm
*By signing below: I understand that the training is mandatory and will make plans now to attend. If I am unable to make this training I understand that I will not be able to attend camp this summer.
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Full Legal Name
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First Name
Middle Name
Last Name
The name I prefer to be called.
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Current Drivers License Number (A photocopy of license must accompany application)
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Please also upload a current photo of yourself.
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Gender
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Male
Female
Current Age
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Marital Status
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Street Address
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City, State, Zip
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E-mail
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Phone Number: Best one to contact you
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Area Code
Phone Number
What church do you attend?
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Occupation
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Name of Employer
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Number of Years At current employer
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Emergency Contact
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Relationship
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Phone (Emergency Contact)
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T-Shirt Size
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Adult Small
Adult Medium
Adult Large
Adult X-Large
Adult XX-Large
Adult XXX-Large
Have you received certification in any of the following?
CPR
First Aid
Life Guard
Nurse
EMT
Counseling or Therapy
Please describe why you wish to return as a volunteer for RFK
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Medical History
Camp can be physically tiring, even exhausting. The facility or activities may require volunteers to manage uneven terrain, require hiking, climbing, running, swimming, lifting, stairs, and other strenuous activities depending on the volunteer position. Your medical condition (physical fitness, recent or chronic injuries, allergies, physical or emotional limitations, etc.) and even the medications you take may be affected by the activities, the foods served, the emotional challenges with the kids, or the sleeping conditions. (Note: Volunteers who stay in the sleeping quarters with the children are not allowed to have medications in those quarters. Medications must be kept in other secure locations as designated by Camp Leadership.)
Do you have any medical, emotional, or mental health conditions?
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No
Yes
If yes, please describe:
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Do you take any medications?
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No
Yes
If yes, please list medication, reason and any side effects:
Have you had any serious illness, injuries, or medical operations in the last three years?
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No
Yes
If yes, please list:
Have you had any physical handicaps or conditions preventing you from performing any type of activity?
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No
Yes
If yes, please list:
Do you have any food allergies? If so do you require a special diet at camp?
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Do you follow a special diet that will require you to provide your own food?
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Personal Growth
If you were abused, neglected or abandoned as a child how did that affect you at camp?
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Please describe your spiritual growth since you have been a RFK volunteer.
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How has RFK impacted your life?
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What current ministries or activities are you involved with at your church or with another organization?
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Have you worked with or associated with children of abuse, neglect or abandonment this past year?:
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Do you wish to stay in the position you served in last year?
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If no please tell us what position you would like to be considered for.
I would prefer my campers to be:
6 years old
7 years old
8 years old
9 years old
10 years old
11 years old
12 years old
Criminal Background
Have you ever been convicted of or pleaded guilty to any crimes including municipal, state and federal?
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No
Yes
Have you ever been placed on probation, received a Suspended Execution, Suspended Sentence or Suspended Imposition of Sentence for any offense involving a minor child ( a child under 18) or been placed on ANY local, state, or federal sexual registry?
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No
Yes
Have you ever been sued in a civil court of law where the allegations in the suit involved illegal, inappropriate, or sexual conduct or contact with a minor child?
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No
Yes
Have you ever subject to any court order involving any sexual, physical or verbal abuse including but not limited to any domestic violence or civil harassment injunction or protective order?
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No
Yes
Have you ever resigned, been terminated or been asked to resign from a position, whether paid or as a volunteer, due to a complaint(s) of sexual, physical or verbal abuse of minors?
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No
Yes
If you answered "yes" to any of the above, please explain:
REPRESENTATIONS AND RELEASE
I understand that For The Children maintains 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 FTC 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 FTC 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.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. 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. In consideration of the receipt and evaluation of this Application by the sponsoring Church or RFK Camp Leadership, 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 FTC, the sponsoring church and RFK Camp Leadership harmless from any damages created by my unwarranted attempt to collect damages for providing information described above. 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. I understand that submission of an application does not guarantee me acceptance as a volunteer. I further understand that should the FTC Leadership extend an offer to me as a volunteer, it is for no specific duration and may be revoked by either the sponsoring church, the RFK Camp Leadership, or me at any time, with or without cause. I understand that none of the documents, policies, procedures, actions, statements of FTC, the sponsoring church, the RFK Leadership or their representatives and agents used during the volunteer application process is deemed a contract, real or implied. If accepted as a volunteer, I agree to conform to the rules, regulations, policies, and procedures of FTC while serving as a volunteer, and understand that such compliance is a condition of remaining a volunteer. I have carefully read the above Application and this Acknowledgement and Release, and know and understand its contents; I also know the above is a legally binding agreement. I sign this Application and Release of my own free will.
Signature
Thank you for your interest in being a part of the RFK Team!
The directors will be in contact with you soon.
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