New Staff TRAC Application

TEEN REACH ADVENTURE CAMP CAMP COUNSELOR/STAFF APPLICATION
Girl's T.R.A.C.: 7/11/2025 to 7/13/2025

Boy's T.R.A.C.: 7/18/2025 to 7/20/2025
Date*

MonthDayYear
Name*

First NameLast Name
Street*
City*
Zip Code*
State*
Cell Phone*
For the cell phone number above do you want to receive SMS messages regarding training and other communications from the Bremerton TRAC Leadership phone number: 1 (877) 571-0088?

Yes - I OPT-IN to receive SMS messages sent to the phone number listed above
Home Phone
E MAIL*
example@example.com
Birth Date*

MonthDayYear
Biological Sex:*
Marital Status*
NOTE: as part of Teen Reach requirements, all volunteers must be living according to biblical standards of purity.
Emergency Contact*
Phone Number:*
T-Shirt Size:*

Adult SmallAdult MediumAdult LargeAdult X-LargeAdult XX-LargeOther:Women's style/cut
T Shirt Size Other:
Have you ever been abused, neglected, or abandoned?*

NoYesYes, but prefer to discuss in person.
Have you committed your life to Jesus Christ?*

YesNo
Could you lead a 15-minute devotion for your campers with provided materials?*

YesNo
Which church do you presently attend?*
Pastor's Name*
Phone*
I have read, agree with, and will comply with the Teen Reach Statement of Faith, Volunteer Standards, and Position Statement.*

NoYes *Scan the QR code or follow hyperlink:
Yes *Scan the QR code or follow hyperlink:

Statement of Faith
Have you ever been arrested for a criminal offense?*

YesNo
Have you ever been arrested for sexual misconduct?*

Yes NoNo
Have you ever been convicted of sexual misconduct?*

YesNo
Have you ever taken drugs other than those prescribed by you physician?*

YesNo
If you answered "yes" to any of the questions above, please explain
High School*
Date of Graduation
College
Date of Graduation
Other
Date of Graduation
Do you have a certification in the following?

CPRFirst AidLifeguardNurseEMT
Have you previously served at another Teen Reach Adventure Camp program?*

YesNo
If YES, what location was the Teen Reach Adventure Camp? If NO, please put N/A.*
Why do you wish to be a volunteer at T.R.A.C.?*
Please describe your previous experience working with children or teenagers*
Do you have previous raining/experience working with abused, neglected or abandoned children/teens?*

YesNo
If so, how?
Place an "X" next to the words which accurately describe you:

Gentle Sarcastic Kind Considerate
Type a question*

TimidGentleImpatientNervousLovingMatureSarcasticPatientAngryDeliberateCongenialKindStubbornStudiousSelfishSecureConsiderateAbrasiveTrustworthyMotivatedVerbalOrganizedImpulsiveIntelligentInsecureRelaxedTactfulCompassionate
List five strengths and weaknesses you have in working with teenagers or children (please be specific):
My Strengths are:
1.*
2.*
3.*
4.
5.
My Weaknesses are:
1.*
2.*
3.*
4.
5.
Can you hike at least 2 miles?*

YesNo
Do you have any medical conditions?*

YesNo
If yes, please explain
Do you take any medications?*

YesNo Please list:

Please List:

	Medication	Reason	Possible Side Effects

Please select any food allergies you have or dietary restrictions*

NoneEggsFishMilkPeanutsShellfishSoyTree nutsWheatOther

References (one professional, one ministry, one personal):*

	Name	Email	Phone Number
Professional
Ministry
Personal

I am interested in becoming a mentor.*

YesNo
I certify, under penalty of perjury, that my signature below signifies this information is true and correct to the best of my knowledge. I give permission for T.R.A.C. to request background checks for me to become a staff member/camp counselor for Teen Reach Adventure Camp.
Name (please print)*
Signature*

Clear
Date*

MonthDayYear
Should be Empty:

TEEN REACH ADVENTURE CAMP CAMP COUNSELOR/STAFF APPLICATION