Camp Volunteer Leaders Application Form 2025

Chosen Valley Camp Volunteer Leaders Application Form

This form is for all leaders aged 17 years and older. If you are aged 13-16 yrs please use the Holiday Camp Junior Leaders Application. This form should be filled in by the person applying.
Which camp are you applying to be a leader for?*
Leader Personal Details

The form is individual, if you have more than one person from the same household please use a separate form .
Name of applicant *

First NameLast Name
Phone Number*
Please enter a valid phone number
Email*
example@example.com
Gender*

MaleFemale
Date of Birth*

DayMonthYear
Are you 18 years or older*

YesNo
Address where applicant normally resides*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Have you served as a Camp Volunteer Leader in 2025?*

YesNo

Personal Information
Are you a Christian*

YesNo
Why do you want to be a camp leader?
What experience/training/skills do you have that might be useful as a leader?
What if any musical abilities do you have?
Do you have a current First Aid Certificate*

YesNo
First Aid Expiry Date

DayMonthYear
List any paid employment (including part-time work) that you have been involved in over the past 5 years.

Swimming / Health/ Dietary Information

Campers
Applicant Swimming Ability*

Non-SwimmerSwimmerConfident Swimmer
Doe you have any allergies or health conditions that we should be aware of?

YesNo
Please explain
Do you have any food allergies?

YesNo
Please explain
Please select if you have any of the following dietary restrictions?

Dairy FreeGluten Free

Parent/Caregiver Permission

All leaders aged 17 years are required to have parental permission to attend camp.
Name of Parent/Caregiver *

First NameLast Name
Relationship to Applicant*
Email*
example@example.com
Phone Number*
Please enter a valid phone number
Permission: Parent/caregiver gives permission for their child to attend camp as a leader*

Yes
Parent / Guardian Signature*

Clear
Date Signed*

DayMonthYear

Leadership Suitability
Do you have any criminal convictions against you?*

YesNo
Have you had any dealing with the Police or other authorities that may affect your position as a leader ?*

YesNo
Have you ever been asked to stand down from any leadership role (particularly with children) due to any alleged misconduct or inappropriate behaviour?*

YesNo
Please provide further details

Referee

For all applicants who have not previously served as camp leaders at Chosen Valley we require: one written and one verbal reference. These can be a pastor, teacher, employer or close family friend who is aged 18 years or older and not an immediate family member.
Name for Verbal Reference *

First NameLast Name
Verbal Reference Phone Number*
Please enter a valid phone number
Relationship to Applicant*
Written Reference*

I will email this directly to the office at bookings@chosenvalley.org.nzI have uploaded this below
Cancelof

Police Vetting

If you are 17 years or older, it is a requirement that all volunteer leaders be police vetted every 3 years. This process can take some time so we suggest that applicants who are 16 years begin this process. The "Request & Consent" form can be downloaded at https://www.police.govt.nz/about-us/publication/police-vetting-forms and also requires two forms of identification be provided.
Applicant has a current Police Vet with Chosen Valley Camp*

YesNoUnsure
Police Vet Request & Consent Form*

Please email me Police Vet documents to be completed and returned to Chosen Valley CampI have completed the form and uploaded it below
Cancelof

Declaration

I understand the information I have provided via this application will be confidential and used for the purpose of establishing suitability for leadership. I undertand that this application does not automatically guarantee acceptance.
I have read the Camp Volunteer Leader Agreement and agreed to the responsibilites of a Camp Volunteer at Chosen Valley Christian Camp.*

Clear
Date*

MonthDayYear
Date
Once you have submitted your application, we will assess your suitability and be in contact within 7 days with further information.
Should be Empty:

Chosen Valley Camp Volunteer Leaders Application Form