2012ywccounselorapplicationform

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					                                  2012 YWC Summer Youth Camp
                       Screening Form & Application for Youth Camp Workers
                                 Send to: YWC Campgrounds ~ P.O. BOX 157 ~ Jellico, TN 37762
                                       Completed forms must be mailed by May 31st, 2011

(PLEASE PRINT)
Name _______________________________________________________________________________
      First              Middle             Last               (Maiden)
Address ____________________________________ State ________________ Zip ________________
Sex      M     F     Date of Birth _____/_____/________ Social Security # ________-_______-__________
Phone: Day (_______) _________________________ Evening (_______) _________________________
Local Church ________________________________ Pastor ___________________________________



REQUIREMENTS FOR YOUTH CAMP WORKERS
You must be at least 15 years of age to volunteer as a JR Camp help, 17 years of age for JR High Camp help, and 22 years of age for
TEEN Camp help. You must also be a regular attendee of a local church, must submit a complete screening form/application, and must
have a signature endorsement by your Pastor.


WHAT IS A YOUTH CAMP WORKER’S JOB?
A youth camp worker may be requested to do a particular assignment whether it is kitchen, dorm leader, etc. It is important to understand
that our youth camp has a “team” approach. Each worker must be willing to accept daily assignments according to the youth camp needs.
Remember, we are here for the kids of the camp. Our spiritual duty is to pray with them and for them whether it is in church, in your dorm,
or wherever the opportunity arises. They are our first priority!


PLEASE CHECK THE CAMP(S) YOU WILL BE ATTENDING
_____ JR CAMP                                  _____ JR HIGH CAMP                            _____TEEN CAMP
(Ages 6-10) June 11-14               (Ages 11-14) June 18-21                        (Ages 15-21) June 25-29


CHURCH HISTORY, YOUTH WORK, SPIRITUAL STATUS
How long have you been saved? ______________________________________________________________________
Have you ever been a counselor at a YWC Camp? ________________________________________________________
What kind of experience do you have working with youth that can help at camp this year?
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
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      IF YOU ARE UNDER THE AGE OF 18, PLEASE HAVE YOUR PARENT/GUARDIAN SIGN THIS MEDICAL RELEASE BELOW:
In the event my child ______________________________ needs emergency medical attention, I hereby give my consent for the officials of
the YWC Camp to seek such medical assistance. I further understand that the camp will make every attempt to notify me of such action as
soon as possible.
Parent Signature: ______________________________________Date: ___________________________
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Have you ever been convicted or pleaded guilty to any crime?
_________________________________________________________________________________________________
                                        RELEASE FOR CRIMINAL RECORDS CHECK
I hereby consent for the YWC Youth office of the Church of God Mountain Assembly to seek from local law enforcement any information
which pertains to any record of conviction contained in its files or in any criminal file maintained on me whether local, state, or national. I
hereby release the Police Department from any and all liability resulting from such disclosure. When signing this consent, I realize that any
information obtained will remain disclosed to the Youth office of the Church of God Mountain Assembly.
Signature: ______________________________________________________________ Date: _________________________________
Signature: ______________________________________________________________ Date: _________________________________

				
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posted:10/2/2012
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