Apply to Serve with Us!
We're so excited and grateful for you applying to volunteer at Camp Illiana's 2025 Winterfest! This event is designed for youth entering 3rd-6th grade! Please complete these additional questions as part of the volunteer approval process, and we can't wait to serve with you!!
Full Legal Name
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First Name
Last Name
Cell Phone
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Please enter a valid phone number.
Email
*
example@example.com
What is your T-shirt Size?
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Please Select
Small
Medium
Large
XL Large
2XL Large
3XL Large
4XL Large
Current Church Home
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Did you serve as a volunteer in 2024 at Camp Illiana?
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Yes
No
General Information
General Information
Home Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Emergency Contact Name
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First Name
Last Name
Emergency Contact Name Cell Phone
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Please enter a valid phone number.
Background Information
Background Information
Date of birth
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-
Month
-
Day
Year
Date
Marital Status
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Single
Married
Divorced
Seperated
Have you been baptized by Immersion?
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Yes
No
Please list all previous volunteer work or employment involving children or students.
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Please list any City/County and State which you have lived, worked, or attended school during the last ten years.
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List any talents, vocations, preparation, training or other experiences that have equipped you to work with campers.
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Why do you want to work with campers at Camp Illiana?
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Do you have a preference concerning the age group or sex of campers?
Yes
No
What is that preference?
What is the reason for that preference?
When you are unhappy, angry or emotional about a person or circumstance, what do you do?
What is your philosophy concerning redirection or discipline of children?
Have you experienced any significant physical or emotional stressors within the past year, such as the loss of a parent, spouse, or child, extreme ill health, or any emotional or physical crisis? If so, please briefly explain.
Yes
No
Please Explain
Have you ever physically or sexually abused a child?
Yes
No
Do you consider yourself to have been physically or sexually abused as a child?
Yes
No
Legal History Information
Legal History Information
Have you ever been convicted of a criminal offense (felony or misdemeanor) involving moral turpitude or violence? (Crimes of moral turpitude involve fraud, theft or dishonesty.) Answer “yes” if you have entered a plea agreement, including a deferred sentence or deferred judgment arrangement in connection with a criminal case. Answering “yes” does not necessarily preclude an applicant from volunteering.
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Yes
No
1. Please Explain
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Have you ever been the subject of a civil lawsuit involving sexual misconduct, sexual harassment, sexual abuse, or other immoral behavior or conduct involving adults or children?
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Yes
No
2. Please Explain
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Have you ever been the subject of an investigation or allegation of sexual misconduct, sexual abuse or sexual harassment involving adults or children?
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Yes
No
3. Please Explain
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Have you ever been charged with a sexual offense, offense relating to children, or crime of violence?
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Yes
No
4. Please Explain
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Have you ever reported to any organization or registry for abuse or misconduct involving children?
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Yes
No
5. Please Explain
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Do you have any disciplinary action or investigation pending by an employer, other organization, professional association, or licensing body, for violence, sexual misconduct, or misconduct involving children?
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Yes
No
6. Please Explain
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Have you ever been disciplined or dismissed from any volunteer or employment position for any reason or following an allegation of sexual misconduct, physical aggression, verbal aggression, or other inappropriate behavior or conduct?
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Yes
No
7. Please Explain
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Have you ever been reprimanded, or asked to leave or end your involvement/work in any program or organization providing services to children?
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Yes
No
8. Please Explain
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Have you ever been the subject of a complaint or disciplinary proceeding concerning any professional license or professional affiliation held by you?
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Yes
No
9. Please Explain
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Do you now or have you ever sought out or intentionally viewed child pornography?
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Yes
No
10. Please Explain
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Statement and application Submit!
Statement (Please read carefully before signing)
I understand and agree that it is critical to Camp Illiana's mission and ministry that all volunteers conform to the highest standards of safety, interpersonal conduct, and sexual morality. I affirm that I will strictly comply with Camp Illiana’s policies and procedures, including those concerning child safety and protection, sexual abuse and misconduct, and interpersonal relationships. I understand and agree that my failure to abide by such policies and procedures may result in my immediate dismissal.My responses above are true and correct. I understand and agree that any false answers or statements made by me on this application or any supplement thereto, or any false statements made to the representative(s) of Camp Illiana during the volunteer approval process, will be sufficient grounds for not allowing me to volunteer or immediately discharging me, no matter when discovered.I HAVE CAREFULLY READ, UNDERSTAND, AND AGREE TO THE FOREGOING “APPLICANT STATEMENT” AND FURTHER UNDERSTAND AND AGREE THAT A COPY OF THIS APPLICATION SHALL BE AS VALID AS THE ORIGINAL.
Signature
*
Date of Signature
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Month
-
Day
Year
Date
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