Volunteer Staff Application

Medical History
Alberta Health Number*
Family Doctor
Do you suffer any medical/emotional/behavioral/mental conditions that would in any way restrict participation in typical activities at camp including land or water sports?*

yesno
If yes, please explain.
Please outline what kind of adjustments could be made to accommodate.
Do you have any allergies?*

yesno
If yes, please explain.
Are you on a special diet?*

yesno
If yes, please explain.
Are there any medications that may not be administered to you?*

yesno
If yes, please explain.
Emergency Contact
Person to Contact in case of emergency*

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Date*

MonthDayYear
Date
Signature*

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A Little Bit About You...
Why are you applying for this position?*
If you have attended camp as a camper, briefly state your experience.*
If you have served at camp previously, briefly state your experience.*
How many years of experience do you have serving at camp?
Briefly describe how you came to salvation in Jesus Christ.*
Please describe how you would lead a 10 year old to Christ. Use Scripture.*
How is your current relationship with Christ? How is your devotional life? Prayer life? What is God teaching you? In what areas do you need further growth?*
What church are you currently attending? Please describe how you feel about participation in a local church?
How are you currently serving in your local church? In your school?*

References

Please provide the names and addresses of your Pastor/Youth Pastor and 2 adults over the age of 25 years who are not your relatives. Please inform them that you have used their names. Please email a copy of the Character Reference form to each of your references, to be returned to Riverside Bible Camp by them.
Reference 1 (Pastor/Youth Pastor)*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Reference 2*

First NameLast Name
Relationship to you*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Reference 3*

First NameLast Name
Relationship to you*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Confidentiality Waiver

To be completed by applicant
I authorize the release of the disclosed information by the person completing this character reference/recommendation for the consideration of the applicant. I waive my right or privilege to inspect or challenge the contents of this reference.

I understand that the information will be held in confidence by Riverside Gospel Fellowship and will not be released to anyone (other than the director and/or board members) without the permission of the person giving such character reference, or in the absence of a court order, subpoena, or laws requiring the disclosure of such information.
Date*

MonthDayYear
Date
Name*

First NameLast Name
Signature*

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Signature of Parent/Guardian (if under 18)

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Volunteer Staff Application

Medical History

Emergency Contact

A Little Bit About You...

Skills and Abilities

References

Confidentiality Waiver