Phone number *
Phone type Mobile Home Work Other
Gender *
Select… Male Female
Adult T-Shirt Size *
Select… S M L XL XXL XXXL
Position Applying for: (click all you desire to serve in) *
Do you have a Valid Driver's License? *
Do you have car insurance? *
Do you have any special skills or qualifications? (Nurse, Lifeguard, CPR Trained, Working with youth/teens with special needs, etc.) *
Tell us why you want to serve for our Camp program. Please include what you can provide for the kids in order to help them get the most out of their experience. *
Do you sing or play an instrument for your church's worship services? If yes, please share in what ways you participate. *
Do you have any other experience in working with Teens or Youth that you think might be helpful in your serving at camp? (ie. coaching, extra curricular activities, mentoring, etc.) *
Have you been approved to work in the Youth & Family/Children's Ministry/Kingdom Kids program of your local congregation? *
If NO, please see your Children's Ministry Leader (CML) to get approved. You must be approved in order to be selected to serve at Camp. You are responsible for following up on this process.
Please list all medications, prescription and non-prescription, taken routinely. Be sure to include the name of the medication, the dosage, and when and why you take it. If none, please write "N/A." *
Bring medication in the ORIGINAL PACKAGE/BOTTLE that identifies the name of the drug, the dosage and frequency, and if applicable, your name and the name of the prescribing physician.
Please list any allergies (medications, food or environmental). If none, please write "N/A." *
Please identify any chronic or recurring illness/conditions. If none, please write "N/A." *
Do you have a condition that requires you to carry an epinephrine pen or inhaler? *
Do you have health insurance? *
Should it be necessary for me to receive medical attention/treatment while participating in the camp activities, I hereby give my permission for the person(s) leading or directing these activities to render medical assistance or administer medical treatment, as a physician/medical professional deems appropriate and necessary. I also give my permission for the person(s) leading or directing these activities to use their best judgment to otherwise render assistance (i.e. First Aid, CPR, etc.) in the event of injury or illness.
I understand that the Orlando Church of Christ or any person(s) leading or directing these activities has no insurance coverage for medical or hospital costs for me, which are associated with injury or illness occuring in the course of these activities (unless the participant is already covered under the church's employee health plan). Therefore, any costs incurred for such medical attention/treatment shall be my sole responsibility.
I further authorize any references or churches listed in this application to give you any information (including opinions) they may have regarding my character and fitness for children or youth work. In addition, I authorize the Orlando Church of Christ to do a background check on me at their discretion. In consideration of the receipt and evaluation of this application by Orlando Church of Christ, I hereby release any individual, church, youth organization, charity, employer, reference, or any other person or organization, including record custodians, both collectively and incidentally, 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 understand that upon my written request, I will be given a copy of the background report and, when applicable, a written description of my rights under the Fair Credit Report Act.
Primary campus
Select… Campus Ministry East Region North Region Orlando Church of Christ Southwest Region
Submit A copy of your responses will be sent to your email address.
