Camp Good News Registration Form

Camp Good News
Staff Application , 2010
6205 Delany, Hitchcock, TX 77563
Phone: 409 316 0501 Fax: 409 986 4219
Web: campgoodnews4u.net
Email: campgoodnews4u@yahoo.com

MINISTRY INFORMATION
How did you hear about Camp Good News?*
What do you expect from a summer at Camp Good News?*
What are some strengths that you would bring to Camp? Weaknesses?*
Have you ever worked at another camp? Been a camper at another camp?*
What experience do you have working with kids?*
How flexible do you consider yourself? Are there any parts of the camp that you would not be as enthusiastic about?*
How would your closest friends describe you in terms of personality, strengths & weaknesses?*
Have you ever been convicted of a felony or misdemeanor?*

YES NO
If yes please provide convictions, dates, & circumstances:
MINISTRY AGREEMENT
We will run a criminal background check; this is for your safety, the peace of mind of parents, and the safety of the campers. The information below is a quick reference for us. Another form for a background check will be attached to this application. You must fill it our as well. Please answer the following honestly:
Have you ever (1) been adjudged liable for civil penalties or damages involving sexual or physical abuse of a child, (2) been subject to a court order involving sexual or physical abuse of a child, or (3) had your parental rights terminated because of a sexual or physical abuse of a child?
....*

YES NO
If yes, please explain
Can you sincerely agree to the following:
You will put the camper’s interest and welfare above your own?*

YES NO
You will make it a goal to get along well with other staff members, volunteers, and directors?*

YES NO

REFERENCES
REFERENCE #1
First Name:*
Last Name:*
Phone Number:*
Work Number:

Address:

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

E-mail:*
Relationship:*
Title:*
Organization:*
REFERENCE #2
First Name:*
Last Name:*
Phone Number:*
Work Number:*

Address*

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

E-mail*
Relationship:*
Title:*
Organization:*
REFERENCE #3
First Name:*
Last Name:*
Phone Number:*
Work Number:*

Address:*

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

E-mail:*
Relationship:*
Title:*
Organization:*

PICTURE RELEASE FORM
I hereby consent to the use (full or in part) of all video tapes and/or pictures taken of me by Camp Good News staff for use at Camp Good News.
Camper/Counselor's Name:*
First Name Last Name
Date:*
Month Day Year

Address:*

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

Please complete if the subject is a minor under the laws of the state where modeling, acting or performing camp activities is done:
Legal Guardian (signature)*
First Name Last Name

Address*

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

AUTHORIZATION TO RELEASE INFORMATION
I certify that the answers given in the accompanying Camp Good News Staff Application are true and complete to the best of my knowledge. In the event of employment, I understand that false or misleading information given in my application, discloser form or interview may result in discharge.

I understand that Camp Good News/Retreat Center to which I am applying or its agent will be investigating my background, references, character, employment, criminal or police records (including those maintained by both public and private organizations) and public records for the purpose of obtaining information which may be material to my qualifications for employment.

I herby authorize each employer, volunteer entity, and any other person or entity to release all such information to Camp Good News.

I understand that by releasing this information to Camp Good News or its agent that my employer, former employers, or any person or entity will not be vouching for its accuracy, and I agree not to bring any legal action against my current employer my former employers, volunteer entities, or any person or entity for their response to the Camp Good News network or its agent’s inquiry.

I understand and waive my right to privacy in this investigation and release and hold harmless Camp Good News /Retreat Center to which I am applying, Camp Good News, its agent and any person or entity which provides information in pursuant to this authorization from any liability.

I understand and agree that if hired, my employment will be at-will in nature and may be terminated, with or without cause, at any time, by myself or by Camp Good News. I also understand that this written statement supersedes any and all oral representations made by agents or representatives of Camp Good News.

It is my understanding that this employment application, or the granting of an oral interview, does not represent a contract of employment or a promise of future benefits.

I authorize the aforesaid parties to treat a photocopy of this release as though it is the original executed copy.
Signature:*
First Name Last Name
Date*
Month Day Year
Parent/Guardian Signature if applicant is under 18:
First Name Last Name
BACKGROUND CHECK FORM
You MUST complete and return the Background Check Form provided on the Staff/Counselor page or your application is incomplete, and you will NOT be eligible to work for Camp Good News. Please mail, email, or fax the Background Check Form to Camp Good News at:

Email: www.campgoodnews4u.net
Fax: 409.986.4219
Mailing Address: 6205 Delany Rd, Hitchcock, TX 77563

or you may upload the completed form below.
Completed Background Check Form:

Double click on the submit form button (it will take a few seconds to submit)
Should be Empty:

2010 Staff Application for Camp Good News

SCHOOL IMFORMATION

CHURCH LIFE

PERSONAL HISTORY

EMPLOYMENT HISTORY

CAMP EXPERIENCE

CERTIFICATIONS

CAMP SKILLS & INTERESTS

ARTISTRY

MAINTENANCE/KITCHEN

MUSIC

OUTDOOR SKILLS

OTHER SKILLS

MINISTRY INFORMATION

MINISTRY AGREEMENT

REFERENCES

REFERENCE #1

REFERENCE #2

REFERENCE #3

2010 STAFF HEALTH FORM

Allergies

Medication

Permission to Treat Staff Member:

PICTURE RELEASE FORM

AUTHORIZATION TO RELEASE INFORMATION

BACKGROUND CHECK FORM