2019 Alumni Part-time Volunteer Application

Church you currently attend: *

Attending Since:

Month Day Year

What has God been teaching you recently? *

What avenues of Christian growth are you currently partaking in? *

When you are unhappy, angry or emotional about a person or cicumstance, what do you do? *

Have you ever experienced any significant physical or emotional stresses within the past year, such as the loss of a parent, spouse, or child, extreme ill health, or any emotional or physical crisis? If so, explain briefly explain. *

Have you ever physically or sexually abused a child? *

Emergency Contact

Phone Number

- Area Code Phone Number

Doctor's Name

Phone Number

- Area Code Phone Number

Health Insurance or Medicaid Number

Are all immunizations up to date?

Yes No

Date of Tetanus

Do you have any allergic reactions to food, drugs, poison ivy, or insect stings?

Yes No

If so, please describe:

If you have struggled with cutting, bulimia, anorexia, suicide, or any other emotional disorders in the past two years, please describe:

Do any of these affect you:

Fainting Epilepsy Diabetes Hay Fever Asthma

Do you have any medical conditions that might effect your time of service?

Commitment and Release

This is a serious commitment. Please ask God to help you overcome any obstacles that may arise in order to be able to fully carry out your commitment.

I am committed to serving God at Camp David with all my heart and energy for the full time of service. The only thing that will keep me from this commitment would be a serious health issue or a family emergency. I understand that while attending Camp David of the Ozarks I may be involved in various activities including, and not limited to swimming, fishing, horse rides, and other traditional camp activities. I understand the mission for Camp David of the Ozarks is to provide a Christian Camp where one can experience love, find hope, and grow in a relationship with Jesus Christ. I agree with the Statement of Faith (found in the "Introduction") for Camp David. I accept the risks involved in camp activities and do hereby release Camp David of the Ozarks, and all staff and volunteers, from any and all claims for injuries or death sustained by me or my family, whether such injury occurs on or off the camp property. I have read the Camp Policies and will uphold them and submit to the leadership of CDO. I give permission to Camp David of the Ozarks to use camp pictures or videos including myself in promotional and sponsorship material. I understand that Camp David is not responsible for lost clothing or personal property while I am at camp, and I agree to initial my personal items.

I hereby state that I am 18 years or older, and I authorize the release of any criminal history record information to Camp David of the Ozarks.

Yes No

I give permission for Camp David of the Ozarks to secure emergency medical and surgical treatment, and routine, non-surgical medical care for my child while at camp. I further release Camp David of the Ozarks, and all staff and volunteers, from all liability of bodily and personal injury sustained by myself or my child.

Yes No

By typing my name in this box, I agree to the above statement: *

If applicant is under 18 years old, a parent must type their name in this box to give consent:

Date *

- Month - Day Year

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

2019 Alumni Part-time Volunteer Application

Personal & Christian Walk

Medical Information: