Junior Staff Forms — Faith Adventure Camp

junior Staff Application

This application is to be completed by all those desiring a ministry position involving the supervision, assistance or instruction of children. It will be used to help Faith Adventure Camp provide a safe and secure environment for those children who participate in our camp.

Medical Information Form

This form is to be filled out by the parent or guardian for minors, and by adult staff members for themselves.

Name

First Name

Last Name

Birthdate

MM

DD

YYYY

Gender

Male

Female

Email

Parent, Guardian or Spouse

First Name

Last Name

Alternative phone

(###)

###

####

Home Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

In case of an emergency please notify

First Name

Last Name

Phone

(###)

###

####

Alternative Phone

(###)

###

####

Emergency Contact Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Health History

Allergies

Date of last tetanus (DpT) immunization

MM

DD

YYYY

Current regular medications?

Yes

No

Dietary modifications?

Yes

No

Name of family physician

First Name

Last Name

Physician's phone number

(###)

###

####

Name of Health Insurance Carrier

Policy or Group Number

Identification Number

Additional health information or suggestions

After submitting the Medical Information form, please email a copy of both sides of your insurance card (and immunization record, or waiver, if under 18) to faithadventurecamp@gmail.com, or text to 602.206.7382. Your application will not be considered complete until we receive this documentation.

The information contained in this application is correct to the best of my knowledge. I understand that any omission of material fact on this application may be grounds for rejection of this application and/or termination of FAC responsibility. I understand that the personal information will be held confidentially by the camp staff. Should my application be accepted, I agree to follow the policies and procedures of Faith Adventure Camp and to refrain from unscriptural conduct in the performance of my duties on behalf of the camp.

First Name

Last Name

Digital Signature provided on:

MM

DD

YYYY

PLEASE NOTE: YOUR APPLICATION WILL NOT BE CONSIDERED COMPLETE UNTIL WE RECEIVE ALL OF THE DOCUMENTATION OUTLINED ABOVE. Please call or text 602.206.7382 with any questions.

Junior Staff Activity preferences

JCs assist in teaching crafts for two classes each day, either in the morning or the afternoon.

Some activities that are offered include:

Camp Craft, Nature Study, Group Games, Music, Crafts (painting, woodworking, electronics), Sewing, Arts, Paper Craft, Drama, Hiking, etc.

Tell us about yourself

Name

First Name

Last Name

Email

Cell Phone

(###)

###

####

Home Phone

(###)

###

####

List any elective courses you have taken or hobbies you have (i.e. sports, music, sewing, model cars, etc.) that will help the Activity Director place you as a helper.

If you are a returning JC, what activities have you helped with in the past?

When would you prefer to have free time?

Morning

Afternoon

Do you have a friend preference for free time?

Do you have a particular Senior Counselor or Activity preference?

Dietary Restrictions Form

This form is only intended for specific food allergies, not general food preferences. Please be as specific as possible. While we can make slight adjustments to our current menu, we cannot substitute food items already planned. If you require special food, it’s your responsibility to provide that food and contact Paula Carruth @ 480-558-6469 (paula7@descomp.com) to discuss your special circumstances prior to June 15th.

Name

First Name

Last Name

Email

Cell Phone

(###)

###

####

Please list any MEDICAL DIETARY RESTRICTIONS you have.

Date

MM

DD

YYYY

CAMPER ACTIVITY RELEASE AND SIGN-OUT AUTHORIZATION

While there is trained staff supervision at all times, there are many inherent risks in activities and games that campers are involved in. Most activities are conducted outdoors where there is a possibility of risk or physical injury or harm. I voluntarily choose to allow my child to participate in the camp experience and assume the risk of injury or harm that could result from participation.

On my own behalf and that of my personal representative and heirs, I hereby release Faith Adventure Camp, Mountain Meadow Ranch, and the Board of Directors and Volunteers of Faith Adventure Camp of all liability resulting from any injury or harm while my child participates in any activity with Faith Adventure Camp. My child has permission to attend camp, participate in all activities on or off the camp site under the supervision of the camp staff, and receive emergency medical care if necessary.

Camper Name

First Name

Last Name

My child may participate

List the names and cell phone numbers of all persons, parents included, who are authorized two sign your child out at the end of camp. Only adults with proper ID may sign out a camper.

Parent or Legal Guardian Signature

First Name

Last Name

MEDIA RELEASE

I hereby grant, voluntarily and with full understanding and no expectation of monetary remuneration, Mountain Meadows Ranch Bible Camp, Inc, and Faith Adventure Camp, a license to do the following:

Use and storage of my name and image, by means of digital or film photography, video recording, audio recording, or other documentation, with respect to the activities at Mountain Meadows Ranch Bible Camp or Faith Adventure Camp.
Use of any stored data including my name and image in printed and electronic publications of Mountain Meadows Ranch Bible Camp or Faith Adventure Camp.
Use of any stored data including my name and image for use in various forms of digital media, including but not limited to, websites, social media channels, email campaigns, and YouTube and other video channels, for the purpose of benefiting and promoting Mountain Meadows Ranch Bible Camp or Faith Adventure Camp.
If I am signing this agreement on behalf of a minor child, I hereby warrant that I am the legal parent or guardian of the child listed below and that I have the legal authority to sign this agreement on behalf of the child.

Camper/Staff Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Date

MM

DD

YYYY

Signature of Parent or Guardian

First Name

Last Name

FAC DISCIPLINE POLICY

At Faith Adventure Camp, we strive to provide a fun and safe learning environment. In order to maintain this, we stress the importance of respect for other campers, staff and property. For the benefit of all campers, it is important that children behave appropriately. To ensure this quality and safety each camper must follow the program rules below. If it becomes necessary to take disciplinary action against a camper (or staff), the steps outlined below will be followed. We reserve the right to bypass one or more steps in the process if a situation warrants.

FAITH ADVENTURE CAMP PROGRAM RULES AND REGULATIONS

My child will show respect to all campers, staff, equipment and property.
My child will use appropriate language and treat others according to the Golden Rule of treating others they way they want to be treated.
My child w1ll listen to and follow instructions given to him or her by their Counselor, Activity Leaders, and Camp Director.
My child will maintain a positive attitude and do his or her best to have a fun camp experience.
I understand that if my child persists in continually disruptive behavior, I may be called to pick up my child from camp early at my expense and with no refund of camp fees.

DISCIPLINE POLICY AND PROCEDURES

1st Incident: The camper will receive a verbal warning and an explanation as to why the behavior is inappropriate (whenever possible, this will be done in a one-on-one setting, removed from other campers).
2nd Incident: Staff will determine an appropriate consequence for the camper's actions (examples may include a "time out" or exclusion from participating in an activity). The Camp Director will notify the camper's parent/guardian by phone of his/ her child's behavior.
3rd Incident: The child will be immediately excused from all camp activities and the parent/guardian will be required to pick up his/her child from camp in a timely manner as determined by the Camp Director.

Transportation from camp is the sole responsibility of the Junior Staff’s parent/guardian. There will be NO REFUNDS for Junior Staff expelled from camp due to behavior issues.

Faith Adventure Camp reserves the right to expel any child for a first or second incident in cases of serious behavior problems.

The form below allows you to enter up to three staff or campers with one parent or legal guardian signature. By signing below I hereby acknowledge that we have read aloud and discussed this discipline policy and each person understands and agrees to abide by its terms and conditions.

Camper Name #1

First Name

Last Name

Camper Name #2

First Name

Last Name

Camper Name #3

First Name

Last Name

Parent or Legal Guardian Signature

First Name

Last Name

Date

MM

DD

YYYY

MEDICATION DOSING SCHEDULE

If your child requires daily medication, please download and complete this form and email it to faithadventurecamp@gmail.com along with your child’s immunization record and your insurance card. Please bring the medications listed on this form to camp with you in their original container with your child’s name clearly showing on the container. You can also email all forms to milo.frazier@gmailcom

MEDICATION DOSING SCHEDULE

IMMUNIZATION WAIVER FORM