Application Submission Requirement
$25.00 Non-Refundable Application Fee
Camp Counselor/Staff Application
Sponsored by Lancaster First Assembly of God
44514 20th Street West, Lancaster CA, 93534
CAMP DATES: JUNE 23-28,2019
This is my first time to work at a Royal Family KIDS Camp
I am a retuning counselor/staff member for Lancaster camp
I have served at other Royal Family KIDS Camps
Please also upload a current photo of yourself (headshot).
Date of Birth
City, State, Zip
Phone Number: Best one to contact you
Cell Phone Carrier
Name of Employer
Work Phone Number
Number of Years At current employer
Phone (Emergency Contact)
What Job Would You Like?
Counselor-Stay at camp all week
Activities Center-Go home at night
Teen Staff-Stay at camp all week
Nurse-Stay at camp all week
Night Releif- Go home after shift
Birthday Party- Only works on Thursday
Errand Runner-Must have own car and goes home at night
Have you received certification in any of the following?
Counseling or Therapy
Do you have previous background or training in working with children who have been abused or neglected?
If yes, in what way?
Were you a victim of abuse, neglect, or abandonment as a minor?
Yes, but I would prefer to discuss this in person
If yes, please clarify
Please describe why you wish to be a part of Royal Family Kids Camp and work with children of abuse, neglect, and abandonment
How Did You Hear About Royal Family KIDS?
Do you have any medical, emotional, or mental health conditions?
If yes, please describe:
Do you take any medications?
If yes, please list medication, reason and any side effects:
Have you had any serious illness, injuries, or medical operations in the last three years?
If yes, please list:
Have you had any physical handicaps or conditions preventing you from performing any type of activity?
If yes, please list:
High School Name
Date of Graduation
Personal References* (required for first time staff only) No former employers or relatives.
Physical Addresses Required, (including city, state and zip code). Letters are sent out.
Reference #1 Name, Address, City, State, Zip Code,Phone, & Email
Reference #2 Name, Address, City, State, Zip Code, Phone, & Email
Reference #3 Name, Address, City, State, Zip Code, Phone, & Email
Have you committed your life to Jesus Christ?
Where & When:
What church do you presently attend?
For how long?
Please describe any previous experience working with children:
Please describe any previous experience working with children who have been abused or neglected:
Do you feel you could lead a 15-minute devotion with your campers with materials we provide?
List five (5) strengths you have in working with children: Please be specific
List five (5) weaknesses you have in working with children: Please be specific
How do you feel you would be best utilized at camp?
I would prefer my campers to be:
7 years old
8 years old
9 years old
10 years old
11 years old
Have you ever been arrested for a criminal offense?
Have you ever been convicted or plead guilty to a crime?
Have you ever been arrested for sexual misconduct?
Have you ever been convicted of or plead guilty to sexual misconduct?
Have you ever taken drugs other than prescription drugs or over the counter drugs?
If you answered "yes" to any of the above, please explain:
The information contained in this application is correct to the best of my knowledge. I authorize any references or churches listed in this application to give you any information (including opinions) that they may have regarding my character and fitness for working with children. In consideration of the receipt and evaluation of this application by the sponsoring Church or Royal Family Kids Camp Leadership, I hereby release any individual, church, youth organization, charity, employer reference, or any other person or organization, including record custodians, both collectively and individually from any and all liability for damages of whatever kind or nature which may at any time result to me, my heirs, or family, on account of compliance or any attempts to comply with this authorization. I waive any right that I may have to inspect any information provided about me by any person or organization identified by me in this application.
I have carefully read the foregoing release and know the contents thereof and I sign this release of my own free act. This is a legally binding agreement which I have read and understand.
Thank you for your interest in being a part of the RFK Team!
By submitting this form you give us permission to contact your references and begin the screening process.
Type a question
Non Refundable Fee
Should be Empty:
on monthly & annual plans
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