2025 Part Time Application

Part Time Staff Application

2025 - Iowa Regular Baptist Camp
- Applicants must be 14 years old (federal law) & entering the 8th grade (or above) in the fall of 2025 to be eligible to apply. (Those who are 13 years old & entering the 8th grade should contact IRBC for eligibility.)
- If your application is accepted you will receive info & confirmation for Water & Work Week in May.
- Once you submit the application a pastor's reference will be emailed to you. It is YOUR RESPONSIBILITY to give this to your pastor.
***Please Note***
To submit this form it is required that you upload a photo AND have your parent/guardian's signature at the end. You are not able to return to this form later to finish it, so it will all need to be completed in one sitting.
Personal Information:
Full Name*

First NameMiddle NameLast Name
Photo*

Upload a recent photo of yourself.
Cancelof
E-mail*
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Cell Phone*
Birth Date*

MonthDayYear
Age*
as of June 16, 2025
Gender*
Grade Entering this Fall*
Shirt Size*
Parent/Guardian(s) Names*
Number of Siblings*
Position
Position(s) Desired:*

Kitchen/DiningLifeguard (Must complete Lifeguard App.)
List any specific qualifications/skills for the position applied for:*
List previous camp work experience:*
What other skills or talents do you have that may be used at IRBC?*
Church Information
Church Name & City*
Please include the city name!
Church Phone*
Pastor's Name*
How often do you attend church?*
Are you a member?*
In what ways are you serving the Lord?*
How have you served in the past?
Personal Testimony
When and how did you become a Christian? (Use Scripture)*
If you were to die today, would you go to heaven? Why or why not?*
Since your salvation, what changes have taken place?*
What personal goals do you have in serving at IRBC?*
General Information
Have you ever been convicted of a crime?*

YesNo
Have you ever been accused or convicted of child abuse or molestation?*

YesNo
If yes, explain:
Medical Information
Medications (include reason for taking):
List any physical limitations:
Allergies (include treatment):
Date of Last Tetanus Shot:
*Tetanus shot is not required for employment.
List any "over the counter" meds you should NOT take:
Insurance Company:
Policy Number:
Emergency Contact *

First NameLast Name
Relationship*
Emergency Contact Phone*
Alternate Emergency Contact *

First NameLast Name
Relationship*
Alternate Emergency Contact Phone*
Personal Commitment
"I understand being a staff member at Iowa Regular Baptist Camp means serving and cooperating with camp administration and other staff members as unto the Lord, obeying all camp rules and sacrificing personal desires in the interest of the campers. My chief aim will be to allow others to see the Lord Jesus Christ living in me."
Applicant's Signature
By submitting this form you are agreeing to the above statement.
Parent/Guardian

This portion must be "signed" by a parent/guardian.
"I am in agreement with my son/daughter working at Iowa Regular Baptist Camp. I attest the information given is true. I will be supportive of the camp's standards and guidelines.

I hereby give IRBC permission to give first aid to my child and authorize treatment by any licensed physician in the event of an emergency, illness, or accident during the period my child is training or employed by the camp. I understand the camp's insurance is secondary, and does not cover illness."
Parent/Guardian Signature*

Clear
Today's Date

MonthDayYear
Should be Empty:

Part Time Staff Application

Personal Information:

Position

Church Information

Personal Testimony

General Information

Medical Information

Personal Commitment

Parent/Guardian