REC STAFF REGISTRATION 2026

REC STAFF REGISTRATION
Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Age at beginning of Camp:
Gender at Birth

MaleFemale
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
T-Shirt Size

SMLXL2XL3XL
SELECT CAMPS TO ATTEND- Make sure to read the commitment expectations section on the Rec-Staff Webpage. (We will be giving preference to those who can serve at more camps)

Kids 1 : June 3-6Kids 2: June 9-12Youth 1: June 16-19Youth 2: June 22-26Youth 3: June 29-July 3
Information for Reference:
Name of Church Currently Attending:
Lead/Senior Pastor Name:
Lead/Senior Pastor Email:
example@example.com
Youth Pastor Name:
Youth Pastor Email:
example@example.com
Describe any previous camp staff experience:
Check the box of the areas you are interested in serving most (this does not mean you are guaranteed these areas)

Games MCGames set up and tear downService CoordinationSoundMediaLightingKids Camp Worship Team
Describe any limitations you may have that would keep you from performing certain tasks while at camp
Have you, in the past year, used or had in your possession illegal drugs or contraband?

YesNo
Explain the above answer if "Yes"
Parent/ Guardian or Applicant if 18 years or older
Name

First NameLast Name
Phone Number (Cell Phone is Prefered)
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
List any persons authorized to remove your child from Camp before its conclusion.
Sometimes campers need to be picked up before the conclusion of camp by a family member or close friend due to illness, family emergency, etc. By listing pre-aproved individuals that may need to remove your child from camp prior to its conclusion, you will assist in the timely release of your child to those individuals. Individuals on this list will be required to provide photo ID before your camper will be released to them. The Parent/Guardian will be contacted, to verify permission, if anyone requests to remove your child from camp that is not on this list.
Emergency and Health Information
Emergency Contact #1

First NameLast Name
Emergency Contact #1
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact #2

First NameLast Name
Emergency Contact #2
Please enter a valid phone number.Format: (000) 000-0000.
Date of Last Tetanus Shot

MonthDayYear
Date
Family Physician

First NameLast Name
Any history of health issues:
Registrant/Applicant may be given over the counter, non-prescription medications or applications, not to exceed the recommended dosage for stomach discomfort, burns, cuts, insect bites, rash or scrapes.

YesNo
Health Insurance Information
Covered by Personal Insurance

YesNo
Insurance Carrier
Carriers Phone Number
Policy Holder
Policy Number
Group Number
Parent/Guardian Agreement

I do hereby state that I have legal custody of this child, a minor, who resides with me. While this minor is a registered camper at any NM Ministry Network summer camp, I hereby authorize any director, counselor, staff, dean, or other responsible person of said Camp to consent to any x-ray, examination, anesthetic, medical or surgical treatment, and hospital care, to be rendered to this minor under the general or special supervision and on the advice of any physician or surgeon licensed to practice in the United States, when such medical or surgical treatment is necessary. I certify that the health information and history I have provided is accurate. We give full permission to NM Ministry Network to reproduce any photograph and/or video image of me/my student for promotional usage without obligation to me/my student. I understand that no activity program is absolutely safe and free of risk. I agree to assume full responsibility for myself and that of my family, including minor children. I, on behalf of myself, my children, my assigns and my estate, agree to release and hold harmless NM Ministry Network, its officers, Board, agents or employees for any and all claims for injuries, causes of action, or liability related to participation in any activity of the NM Ministry Network. Should NM Ministry Network, or anyone acting on their behalf, be required to incur attorney’s fees and costs to enforce this agreement, I agree to indemnify and hold NM Ministry Network harmless for all such fees and costs. I have read the rules and agree to abide by them and do hereby give permission to participate in all camp activities. I understand the signature of the parent or guardian of a minor child on this document shall make all provisions of this release and assumption of the risk agreement applicable to and binding on the minor child. I agree that New Mexico law shall govern this release.
Applicant Agreement

I do hereby state that I have legal custody of the applicant, a minor or I am the applicant of 18 years or older. I authorize the NM Ministry Network to make an independent investigation of the applicants background, references, character, past employment ,education, criminal or police records, including those maintained by both public and private organizations and all public records for confirming the information contained on my application and/or obtaining other information which may be material to my qualifications for volunteering for staff at the NM Ministry Network Camps. While applicant is staff at any NM Ministry Network summer camp, I hereby authorize any director, counselor, staff, dean, or other responsible person of said Camp to consent to any x-ray, examination, anesthetic, medical or surgical treatment, and hospital care, to be rendered to applicant under the general or special supervision and on the advice of any physician or surgeon licensed to practice in the United States, when such medical or surgical treatment is necessary. I certify that the health information and history I have provided is accurate. I give full permission to NM Ministry Network to reproduce any photograph and/or video image of the applicant for promotional usage without obligation to applicant or applicants family. I understand that no activity program is absolutely safe and free of risk. I agree to assume full responsibility for myself and that of my family, including minor children. I, on behalf of myself, my children, my assigns and my estate, agree to release and hold harmless NM Ministry Network, its officers, Board, agents or employees for any and all claims for injuries, causes of action, or liability related to participation in any activity of the NM Ministry Network. Should NM Ministry Network, or anyone acting on their behalf, be required to incur attorney’s fees and costs to enforce this agreement, I agree to indemnify and hold NM Ministry Network harmless for all such fees and costs. I have read and agree to abide by the rules and guidelines of the Summer Camp Policy Manual. I do hereby give permission for the applicant to participate in all camp activities. I understand the signature of the parent or guardian of a minor child on this document shall make all provisions of this release and assumption of the risk agreement applicable to and binding on the minor child. I agree that New Mexico law shall govern this release.
Parent/Guardian or Applicant if 18 years or older sign to the Agreement Above
Parent/Guardian or Applicant if 18 years or older

First NameLast Name
View Camper Information and Rules
Once submitted you will receive a confirmation from Austin Poper as to your ability to serve on Rec Staff. Thank you so much for your desire to serve our students at camp!
Should be Empty:

REC STAFF REGISTRATION

Information for Reference:

Parent/ Guardian or Applicant if 18 years or older

Emergency and Health Information

Health Insurance Information

Parent/Guardian Agreement

Applicant Agreement