Return volunteer application

Rocky Mountain Bible Mission (RMBM) Returning Volunteer Application

USE THIS FORM ONLY IF YOU SERVED WITH RMBM LAST YEAR

Reaching the Rocky Mountain West for Christ

Please print clearly and fully complete the entire form. This application also includes a Medical Information and Liability Release. If all pages are not received and filled in, we may not be able to process the application in a timely manner. Every section is required information and the Medical Information and Liability Release must be signed. If you have questions about completing the form, please call the RMBM office at (406) 532-1565 or email us at rmbmoffice@rmbible.org. You may also contact our camps directly: Elohim (406) 295-1115 or email at campelohimoffice@gmail.com Lewtana (406) 535-4805 or email lewtana@gmail.com Utmost (406) 244-0049 or email at CampUtmost@gmail.com

Section 1. General Information

Name

Email address

example@example.com

Mailing Address please include city, state, and zip code

Social Security Number

In what capacities would you like to serve (kitchen, cabin leader, music, maintenance, or crafts)

In what capacities would you rather NOT serve

Your Age

Date of Birth MM/DD/YYYY

Date

Marital Status: Single, Married, Widowed

Section 3. Background Information Has the applicant at any time ever: Been arrested for any reason? Been convicted of or plead guilty, or no-contest to any crime? Engaged in or been accused of any child molestation, exploitation or abuse?

If you answered yes to any of these please give details

Date

Printed name

Our office staff will process this application and notify you when approved. In order to facilitate an appropriately staffed and smoothly run ministry, all volunteers must have the ministry director's approval before you being invited to serve. This signature signifies your acknowledgment of the background that is necessary for serving with Rocky Mountain Bible Mission at Camp Elohim.

Section 4. Parental Approval (Must complete for any minor) For minors (everyone under the age of 18) a parent or legal guardian must sign here granting their permission for you to work with the Mission.

Printed name

Signature

Date

Parents/Guardians If needed how may we best reach you during the day and in the evenings

Section 5. Pastoral Approval Applicant: Please add a contact phone number or email for your pastor or spiritual mentor below. Provide the contact name in the space below.

Email address

Church Name and Address

Phone

Section 6. Applicant Confirmation:

I recognize that Rocky Mountain Bible Mission (RMBM) and its affiliates are relying on the accuracy of the information I have provided here. Accordingly, I attest and affirm that the information provided is absolutely true and correct. I voluntarily release RMBM, its affiliates and anyone listed on this application from liability involving the communication of information relating to my background or qualifications. I further authorize RMBM to conduct a background investigation, if such a check is deemed necessary. I agree to abide by all policies and procedures of Rocky Mountain Bible Mission and its faith statement, and to protect the health and safety of the children or youth assigned to my care or supervision at all times.

Thank you for your interest in serving God through ministry with the Rocky Mountain Bible Mission at Camp Elohim.

Rocky Mountain Bible Mission (RMBM) Medical Information and

Reaching the Rocky Mountain West for Christ

Your safety and health are very important to us. Since we must also meet certain requirements for insurance purposes, it is necessary to have this form completed and signed appropriately. Your application will not be accepted without the information requested here. If the applicant is under the age of 18, a parent or legal guardian must sign.

First Emergency Contact Name

Contact Relationship

Contact Phone

Second Emergency Contact

Second Emergency Contact Phone

Second Emergency Contact Relationship

Section 8. Insurance Information

Medical Insurance Provider if no insurance write NONE and continue

Name of Policy Holder

Policy Number

Name of Preferred Doctor or Clinic

Date of Last Tetanus Shot (if known)

Date

Any Medical or Food Allergies? (if no allergies write NONE)

Medical Physical or Activity Restrictions we should be aware of if no restrictions write NONE

Medication to be taken while at camp must be given by camp nurse if no medications write NONE

Section 9. Authorization and Liability Release Discipline Policy Behavior and/or attitudes deemed unacceptable by the discretion of our Camp Director will warrant the applicant's immediate dismissal. If applicant is a minor, parents/guardians will be notified, and they will be responsible for the removal of the applicant. Legal Consent As parent or legal guardian of the applicant under the age of 18 applying, or for myself being over the age of 18, I hereby grant permission for the above named to volunteer with Rocky Mountain Bible Mission (RMBM) and consent to its Discipline Policy. I also do hereby release RMBM from any and all liability or responsibility due to any injury that he/she/l may incur as the result of, or arising in any way from, participation in activities at or under the direction of RMBM. I am fully aware, consent to accept these risks, and voluntarily agree to allow his/her/my participation in activities. I further understand RMBM often takes photographs or videos of participants during activities or events. I grant permission without compensation that these photographs and/or videos may be used in publications, presentations, websites and promotion of Rocky Mountain Bible Mission. RMBM will not identify me, or the minor applicant, by name or release any other personal information without additional written permission from me.

Printed Name

Signature

Date

RMBM Returning Volunteer Application

Please use the above line to provide dates or age groups you are available to serve with.