Volunteer Application | Crystal Springs Baptist Camp

Name*

First Middle Last

Home Phone

Cell Phone

Email Address*

Home Address*

Street City State ZIP Code

Date of Birth*

Age

Sex

Male

Female

Occupation*

Church You Attend*

City*

Pastor*

PLEASE CHECK THE CAMP(S) YOU ARE VOLUNTEERING FOR*

Explorers (ages 8-9)

Pathfinders (ages 10-11)

Adventurers (ages 11-12)

Junior High (ages 12-14)

Senior High (ages 15-18)

1. Write out your personal testimony in 300 words or less.*

2. Why do you want to volunteer at CSBC?*

3. Please list any other talents, vocations, preparation, training or other experiences that have equipped you to work with children?*

4. Do you have a preference concerning the age group or sex of children or students with whom you would like to work? Why?*

PLEASE LIST AT LEAST THREE REFERENCES. (At least one reference must be a person of the opposite sex & one must be a pastor).

Name	Gender	Email	Phone	Is this reference a pastor?	Actions

There are no References.

Note: Should volunteer dismissal be considered, it will be at the discretion of the executive director.

Primary Screening Form for Crystal Springs Camp

This is to be completed by all applicants for any position (volunteer or compensated) involving the supervision or custody of minors. This is not an employment application form, but rather an instrument to help implement a safe and secure environment for our children and youth ministries. This is a confidential form and the information herein will be accessible only to the administration team of Crystal Springs Camp.

Personal Information

Name*

First Last

Personal Information Date*

Maiden Name (if married, divorced, etc.)

First Last

Social Security #*

Present Street Address*

Street City State ZIP Code

Home Phone*

Date of Birth*

Have you ever been convicted of a criminal offese (felony or misdemeanor)?

Yes

Have you ever been charged with a sexual offense, offense relating to children, or crime of violence?

Yes

Do you consider yourself to have been physically or sexually abused as a child? (This information will be kept entirely confidential.)

Yes

Have you ever physically or sexually abused a child?

Yes

Has someone ever accused you of abusing a child?

Yes

If yes to any of the above questions, please explain*

Volunteer’s Statement

The information contained in this application is correct to the best of my knowledge. I authorize any references or churches listed in this application to give any information (including opinions) that they may have regarding my character and fitness of children or youth work. In consideration of the receipt and evaluation of this form by Crystal Springs Camp, I hereby release any individual, church, organization, charity, employer, reference, or any other person or organization, including record custodians, both collectively or individually, from any liability for damages of whatever kind or nature which may at any time result to me, my heirs, my family, on account of compliance or any attempts to comply, with this authorization. I waive any right that I may have to inspect any information provided about me by any person or organization identified by me in this application. Should my form be accepted, I agree to be bound by the policies of Crystal Springs Camp, and to refrain from unscriptural conduct in performance of my services on behalf of the camp. I realize and agree that any photos or recordings taken of me during the summer may be used in camp promotional material. I further understand that Crystal Springs Camp will thoroughly pursue the safety of minors being served by their ministries. To that end, they may check my name against the list of registered sex offenders in the United States and a background check. I further state that I HAVE CAREFULLY READ THE FOREGOING RELEASE AND KNOW THE CONTENTS THEREOF AND I SIGN THIS RELEASE AS MY OWN FREE ACT. This is a legally binding agreement which I have read and understand.

Applicant's Signature*

First Last

Signature Date*

Comments

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