Heartland Region Youth Camp 2026 Worker Application

QUALIFICATIONS FOR YOUTH CAMP VOLUNTEERS:

1. Should be a member of the Church of God and should be;
- Teen Camp Volunteer Ages:At least 20 years of age for dorm leader
  Must be graduated and at least 18 years of age for support staff.
- Jr. Camp Volunteer Ages:At least 16 years of age for support staff.
  At least 18 years of age for a dorm leader.
- Any exceptions must be approved by the State Director. NOTE: Walk on applications/registrations for volunteers are not permitted or accepted.
2. Shall complete an application form and have it signed by the Pastor of their local church. A pastoral endorsement must be on file for each camp volunteer. During your online application you MUST provide your Lead Pastor's email address for an endorsement.

3. If you are under the age of 18 you should be registered to attend your appropraite week of camp as a camper before you are elagable to sign up to volunteer.

4. It is mandatory that volunteers complete at least one full pre-camp training session for their specific camp. Any exceptions must be made by the State Youth Director.

5. All Church of God camp Dorm Leaders, Administrative Team, and Support Staff are considered volunteers and should carry their own hospitalization insurance.

6. All volunteers must meet screening requirements including but not limited to a criminal background check; and are selected with the approval of the State Youth and Discipleship Board.

7. By agreeing to serve in the Church of God Youth Camp, it is expected that all volunteers will conduct themselves in a manner that exemplifies Christian character and that all youth camp guidelines will be obeyed.

8. Be willing to adhere to all general guidelines, policies and procedures included in the Heartland Region Youth Camp Manual.

The application process may take several days to complete depending on the camp, your application, available space, etc . Please be patient and understand that the Heartland Region Youth & Discipleship Department process a bunch of applications during camp season. If you have not received an email or phone call within two weeks of your submission, please contact us at hrcogyouth@gmail.com

Criminal background checks will be completed by the Heartland Region Youth & Discipleship Department upon receipt of this application. Insurance requirements state that all volunteers in a local church must have a current criminal background check on file for any person that is involved in ministry.
2026 Heartland Region YOUTH CAMP

"Just Keep Swimming"

VOLUNTEER APPLICATION

Read through the entire application, as there have been changes and additions.

Teen Camp | June 29 -July 3 | Ages 13-18
Jr Camp | July 6 -10 | Ages 7-12

Please complete the entire application, ensuring that no entries are left blank. INCOMPLETE APPLICATIONS WILL NOT BE ACCEPTED. If you are accepted to participate as a volunteer, you will receive a confirmation via email with your assignment for each camp. This email will also include information for arrival/departure times, training, and preparations for camp.

**ALL VOLUNTEER APPLICATIONS WILL NEED TO BE SUBMITTED NO LATER THAN JUNE 1st!

STEPS OF ACTION:
1. Complete online registration.

2. You will receive an email saying your form was submitted. A separate email will be sent to your pastor for the endorcement.

3. Once we receive the pastoral endorsement for the applicant, the applicant will be notified by email.

4. If considered, you will be prompted at a later date to complete a mandatory background check.

Criminal background checks will be completed by the Heartland Region Youth & Discipleship Department upon receipt of this application. Insurance requirements state that all volunteers in a local church must have a current criminal background check on file for any person that is involved in ministry. A link will be provided, after the submission and acceptance of your applicaiton, to obtain a background check through Trusted Employee by the Heartland Region Youth & Discipleship Department.
Volunteer Information

Please complete each section in it's entirety. Incomplete applications WILL NOT be accepted.
Is this your first year volunteering?*
Legal Name*

First NameLast Name
Nickname
Gender*
Marital Status*
Current Age Now*
Please enter your current age, not three months from now.
Birth Date*

MonthDayYear
Date
Email*

Confirmation Emailexample@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Have you lived at this address for less than two years?*
Previous Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Preferred Phone Number*

Area CodePhone Number
Alternate Phone Number

Area CodePhone Number
T-Shirt Size *
Your Picture*

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Education Background

Please complete each section in it's entirety. Incomplete applications WILL NOT be accepted.
Please Select The Highest Grade Year Completed*

Health Information

Please complete each section in it's entirety. Incomplete applications WILL NOT be accepted.
Do you have any health problems or physical limitations that would prevent your from working at full capacity during Heartland Region Youth Camp?*
If yes, please explain:
Please explain in detail what your limitations are so we may do our best to review your application
Date of your last Tetanus Shot:*
Do you have any allergies? If yes, please list below:*
Are you currently taking any medications?*
Please list all medications
Health Insurance Information

Please complete each section in it's entirety. Incomplete applications WILL NOT be accepted.
Do you have Health Insurance?*
Insurance Carrier Name:*
Member / Subscriber Full Name:*

First NameLast Name
Member / Subscriber ID Number:*
Insurance Customer Service Phone Number*

Area CodePhone Number
Insurance ID Card Photos:*

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Medical Waiver

With my electronic signature, I agree, that in case of an accident or a serious illness, you have my permission to secure the proper medical treatment required.
Volunteer's Signature (Parent Signature if volunteer is a minor):*

Automobile Information

Please complete each section in it's entirety. Incomplete applications WILL NOT be accepted.
Do you plan on bringing a personal vehicle?*
Car make, model and color*
License Plate *
Policy Holder Name*

First NameLast Name
Phone Number of Policy Holder*

Area CodePhone Number
Address of Policy Holder*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Insurance Company Name*
Insurance Company Phone Number*

Area CodePhone Number
Policy Number*
Policy Expiration Date*
Insurance ID Card Photo*

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Spiritual Status / Church Information

Please complete each section in it's entirety. Incomplete applications WILL NOT be accepted.
Please select all that apply:*

SavedBaptized in Holy GhostSanctifiedBaptized in WaterChurch Member
Are you a member of a local Church of God Church?*

YesNo
Name of local Church of God you attend:*
Lead / Senior Pastor Full Name:*

First NameLast Name
Lead / Senior Pastor Email Address:*

Confirmation Emailexample@example.com
Position you currently hold at your local church:*

Heartland Region Youth Camp Registration / Position

Please complete this section in its entirety. If you Do Not choose a position, one will be chosen for you. Any changes will need to be approved and can be denied/refused depending on position availability. (STATEMENT OF RESERVATION: While no one is rejected to work or attend Heartland Region Church of God Youth Camp on the basis of race, color, or creed, the Heartland Region Youth Director reserves the right to accept or reject an application for volunteer work at Heartland Region Church of God Youth Camps after review of said application reveals that the services of the applicant would or would not be in the best interest and success of the camp. An application may be rejected due to the fact that all positions have been filled for selected camp.)
Please Select Camp Week and Position for Volunteering (If serving multiple weeks or different positions, please click "Add" button)*
Additional Comments

	Yes	No
1. Have you ever been charged, arrested, convicted or pled guilty to any crime?
2. Have you ever been accused, charged or alleged to have committed any act of neglecting, abusing or molesting a child or youth?
3. Have you ever been a victim of abuse (verbal, physical, sexual)? If you prefer, you may discuss the answer to the previous question with a pastor or ministry leader.
4. Have you ever been involved in homosexual activity?
5. Have you ever been accused, charged or alleged to have committed a theft?
6. Are you addicted to prescription drugs?
7. Do you use tobacco in any form?
8. Do you use any type of electronic cigarette or similar device? (ie: vape, Juul, etc.)
9. Do you have problems sleeping?
10. Do you have recurring nightmares or sleep disturbances?
11. Do you have a history of use of pornographic materials?
12. Have you ever been charged with moving traffic violations?
13. Has your driver’s license ever been revoked or suspended?

Volunteer Information

Education Background

Health Information

Health Insurance Information

Medical Waiver

Automobile Information

Spiritual Status / Church Information

Heartland Region Youth Camp Registration / Position

Volunteer's Statement