Summer Camp Staff Reference
Staff Member's Name
*
First Name
Last Name
Your Name
*
First Name
Last Name
Your Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Your Relationship to the Staff Member
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Dependability
*
Does this person carry out assigned tasks with minimal or no supervision?
Maturity
*
Does this person exhibit good judgment and mature character?
Suitability
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Is this person suitable for work in a location where children are present?
To your knowledge, has it ever been alleged that this person has committed child abuse or an unlawful sexual offense? Has this person ever expressed or displayed inappropriate sexual behavior?
*
Yes
No
If you answered "Yes" to the prior question, then please explain.
If "No," then leave this field blank.
Any other comments you would like to share about this person:
Optional
Signature
*
Date
*
-
Month
-
Day
Year
Date
Submit
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