Fall DYR 2025 Staff Registration Logo
  • Staff Application Form       Nov. 7-9, 2025

    Staff Application Form Nov. 7-9, 2025

    Deadline Oct. 15, 2025
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  • Current driver's license information

  • Auto Insurance Information

  • Strict regulations require that you check your auto insurance policies concerning bringing campers or other staff members driving your car. Check before leaving for the retreat.

    If you bring campers or other staff on retreat sponsored activity in your car a copy of your driver's license and a copy of your insurance information must be on file in DYC's office. Drivers must be at least 21 years of age in order to transport campers.

     

  • Emergency Contact Information

  • Personal and Policy Information

  • Personal Conduct:

    Please read carefully the paragraphs below before answering and signing.

     

  • Please read Carefully, Check and Sign

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  • Please Upload a copy of your health insurance card and Covid Vaccine Card. 

     

    If you are unable to upload a copy, please MAIL to: 

    Vivian Crowley

    1354 E. Arlington St.

    Springfield, MO 65803

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  • Staff Health Form and Insurance Information

    Staff Health Form and Insurance Information

    DEADLINE: Oct. 15, 2025
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  • Please include a copy of your insurance card

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  • Health INSURANCE POLICY

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  • Medication or Insulin

  • AUTHORIZATION FOR EMERGENCY MEDICAL CARE

  • I, hereby give my permission to camp officials to call a doctor or emergency medical service and for the doctor, hospital, or medical service to provide medical, to order injection, anesthesia or surgical care should an emergency arise. It is understood that camp officials will make a conscientious effort to locate the emergency contacts listed before any action will be taken. Whether or not emergency contact/contacts listed are contacted I accept the expense of emergency medical or surgical treatment. I hereby authorize Deaf Youth Camp and Baptist Hill Assembly and its employees and agents to dispense medications and attend to other special needs I may need. In the event I'm unable to consciously take my medication I give Deaf Youth Camp's nurse permission to administer all medicines listed as per directions on container or written out. I hereby authorize Deaf Youth Camp and Baptist Hill Assembly, and its employees and agents to attend to other special needs that I may require while attending the event. I understand the camp nurse and/or camp administrator will use the information provided below for emergency contact will be informed regarding my emergency situation and/or condition.

    It is understood that Deaf Youth Camp will provide no medical insurance for such treatment, and that the cost thereof will be at my expense.

    I have informed Deaf Youth Camp of any special medical needs and diagnosis and have provided them with complete and accurate instructions regarding those needs, including any necessary and lawfully prescribed drugs.

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  • In Case of Emergency NOTIFY

    In Case of Emergency NOTIFY

  • If Deaf Youth Camp, Baptist Hill or camp nurse is unable to contact person name listed above please put another person name to contact below:

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  • Other Medical Information

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  • Administration of Over-the-Counter Medications

    Administration of Over-the-Counter Medications

  • This information is for the nurse only. Need to know what over-the-counter medication you can take IF happen emergency you are unconscious/unresponsive. This is for your safety/protection.

    If you've forgotten to bring your over-the-counter medications there are some available in the Nurse's Office during camp. In order for you to receive medication, please authorize each medication by checking the box next to the medication name below, then sign and date. All over-the-counter medications will be administered according to the package dosage directions only unless otherwise documented in the box below.

    You may choose to decline any medication be given to you from the camp nurse. If that is your wish, please select REFUSE MEDS box below.

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  • Food Allergy &        Special Dietary Need

    Food Allergy & Special Dietary Need

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  •   3. If YES, Please write your name on your own food. 

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  • COVID Waiver                   of Liability

    COVID Waiver of Liability

    Please read carefully, then sign and date.
  • Deaf Youth Camp and Baptist Hill Assembly has put in place preventative measures to reduce the spread of COVID-19 and it’s variants; however, Deaf Youth Camp & Baptist Hill Assembly cannot guarantee that you will not become infected with COVID-19 or its variants. Further, attending camp could increase your risk of contracting COVID-19 or any of its variants.

    By signing this agreement, I acknowledge the contagious nature of COVID-19 and its variants and voluntarily assume the risk that I may be exposed to or infected by COVID-19 and its variants by attending Deaf Youth Camp and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 or its variants at Deaf Youth Camp may result from the actions, omissions, or negligence of myself and others, including, but not limited to, Deaf Youth Camp & Baptist Hill assembly, employees, volunteers, and program participants and their families.

    I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to myself (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I may experience or incur in connection with my attendance at the Deaf Youth Camp or participation in Deaf Youth Camp programming (“Claims”). On my behalf, and on behalf of my children, I hereby release, covenant not to sue, discharge, and hold harmless the Camp, its employees, agents, and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of Deaf Youth Camp & Baptist Hill Assembly, its employees, agents, and representatives, whether COVID-19 or its variants infection occurs before, during, or after participation in any Camp program

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  • Social and Digital Media Code of Conduct Policy 

    Adopted on January 1, 2025

  • Social media has been defined in many ways. It includes electronic communications and online activities, such as text messages; email; wikis; and social networking like Facebook, SnapChat, Twitter, and the like; and posting comments, such as on blogs. Because of the blur between personal and professional communications, this Code of Conduct helps explain what is recommended and expected.


    1. Remember all internet postings are permanent — able to be duplicated and may go viral.


    2. Use your common sense. If you wonder whether or not to communicate or post, don’t do it until you consult with Deaf Youth Camp leadership.


    3. For your protection and the protection of Deaf Youth Camp, you are prohibited from using internal or external social media channels to discuss confidential items, legal matters, litigation, or the organization’s financial performance. Confidential information includes anything labeled as such or information not available to the public. When asked by others to discuss any of these matters, you should relay that “Our social media policy only allows authorized individuals to discuss these types of matters. I can refer you to an authorized individual if you’d like to ask them,” and then refer the question to the APPROPRIATE TEAM OR INDIVIDUAL.


    4. Be open and honest about who you are when you communicate. Deaf Youth Camp trusts and expects you to exercise personal responsibility whenever you use social media, which includes respecting the trust of those with whom you are engaging. However, these policies are not meant to interfere with your legal rights to bargain collectively or engage in concerted or protected activities.


    5. Respect your privacy, your coworkers’ privacy, and the organization’s privacy by not providing personal or confidential information without permission. Also, staff volunteers are prohibited from sharing anything via social media channels that could violate another staff volunteer’s right to personal privacy.


    6. Only those officially designated may use social media to speak on behalf of the organization in an official capacity, though staff volunteers may use social media to speak for themselves individually. If and when designated persons use social
    media to communicate on behalf of the organization, they should clearly identify
    themselves as a staff volunteer.


    7. If you are communicating with youth through any digital or social media, act as
    you would if you were communicating in person. Specifically, communicate with
    minors using transparency and, in a group, or do not communicate at all. If it is
    necessary to send an individual message outside of a public area to a minor,
    copy another adult or a parent. Do not initiate a one-on-one relationship (such as
    friending from a personal profile) with a minor.


    8. Do not use Deaf Youth Camp’s email address or social media channels for personal use.


    9. Harassment, threats, intimidation, ethnic slurs, personal insults, pornography,
    obscenity, racial or religious intolerance, abuse, and any other form of behavior
    prohibited by law is also prohibited via social media channels. Do not engage in any
    such behavior and do not make or comment on any such behavior, comments, or
    remarks.


    10. If you are not officially authorized to speak on behalf of Deaf Youth Camp, use a
    disclaimer saying that what you communicate is your personal opinion and not that
    of the organization when you are engaging in conversation on Deaf Youth Camp’s
    social media channels. A example of a social media disclaimers include: “I am not
    an official spokesperson, but my personal opinion is . . . .” This requirement is not
    meant to interfere with your rights to bargain collectively or engage in concerted or
    protected activities but rather to ensure that others can easily distinguish the official position of the organization or the organization’s leadership from those of our volunteers.


    11. Users should use their best judgment when engaging in social media activities and should be on guard against actions and discussions that could harm the interests of our community, faith, or other people.


    12. Before posting photographs of any person, obtain permission from the admin team.


    13. If you see a violation of this Code of Conduct, report it to the DIRECTOR at Deaf
    Youth Camp. If you have questions about the Code of Conduct, please contact the
    Admin Team.


    14. All the Deaf Youth Camp’s other policies apply to the use of digital and social
    media. All communication by volunteers should consider the organization’s values,
    reputation, and policies.


    15. Any violations of Deaf Youth Camp’s Code of Conduct may result in discipline
    and/or termination of volunteer opportunities.


    I have received a copy of Deaf Youth Camp’s Social and Digital Media Code of Conduct. I understand it is my responsibility to become familiar with and adhere to the information contained herein. I understand that these policies are the property of Deaf Youth Camp.

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