2023 Camp Staff Application
Sunday July 16 - Friday July 21, 2023
Full Name
*
First Name
Last Name
Choose one:
*
This is my first time to work at a Royal Family KIDS Camp
I am a returning counselor/staff member for the Yamhill County/Newberg, OR Camp
I have served at RFK or Teen Reach Adventure Camp in other Cities or States
I have served at the Yamhill County/Newberg Teen Reach Adventure Camp
I would prefer to work as a (choose all that apply)
Counselor (assigned two campers for the week)
Staff member (available during the week)
Support staff (assist with setup leading to camp)
Gender
Male
Female
Current Age
*
Marital Status
*
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
E-mail
*
Phone Number: Best one to contact you
*
-
Area Code
Phone Number
Occupation
*
Name of Employer
*
Number of Years At current employer
*
Emergency Contact
*
Relationship
Phone (Emergency Contact)
*
T-Shirt Size
Adult Small
Adult Medium
Adult Large
Adult X-Large
Adult XX-Large
Have you received certification in any of the following?
CPR
First Aid
Life Guard
Nurse
EMT
Counseling or Therapy
Do you have previous background or training in working with children who have been abused or neglected?
Yes
No
If yes, in what way?
Medical History
You will be submitting an up-to-date medical information and release form the 2 weeks prior to camp. The info below is for any situations that need to be addressed ahead of time.
Do you have any medical, emotional, or mental health conditions?
No
Yes
If yes, please describe:
Do you take any medications?
No
Yes
If yes, please list medication, reason and any side effects:
Have you had any serious illness, injuries, or medical operations in the last three years?
No
Yes
If yes, please list:
Have you had any physical handicaps or conditions preventing you from performing any type of activity?
No
Yes
If yes, please list:
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Next
Personal Information* (required for first time staff)
Were you a victim of abuse, neglect, or abandonment as a minor?
Yes
No
Yes, but I would prefer to discuss this in person
If yes, please clarify
Please describe why you wish to be a part of Royal Family Kids Camp and work with children of abuse, neglect, and abandonment
Education* (required for first time staff only)
High School Name
Date of Graduation
College
College Major
Date of Graduation
Other Education
Personal References* (required for first time staff only) No former employers or relatives.
Reference #1 Name
Reference #1 Email
Reference #2 Name
Reference #2 Email
Reference #3 Name
Reference #3 Email
Personal Profile
Have you committed your life to Jesus Christ?
No
Yes
Where & When:
What church do you presently attend?
*
For how long?
Pastor's Name
*
Please describe any previous experience working with children:
*
Please describe any previous experience working with children who have been abused or neglected:
*
Do you feel you could lead a 15-minute devotion with your campers with materials we provide?
No
Yes
List five (5) strengths you have in working with children: Please be specific
*
List five (5) weaknesses you have in working with children: Please be specific
*
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Next
How do you feel you would be best utilized at camp?
I would prefer my campers to be (check all that apply):
7 years old
8 years old
9 years old
10 years old
11 years old
Have you ever been arrested for a criminal offense?
*
No
Yes
Have you ever been convicted or plead guilty to a crime?
*
No
Yes
Have you ever been arrested for sexual misconduct?
*
No
Yes
Have you ever been convicted of or plead guilty to sexual misconduct?
*
No
Yes
Have you ever taken drugs other than prescription drugs?
*
No
Yes
If you answered "yes" to any of the above, please explain:
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 you any information (including opinions) that they may have regarding my character and fitness for working with children. In consideration of the receipt and evaluation of this application by the sponsoring Church or Royal Family Kids Camp Leadership, I hereby release any individual, church, youth organization, charity, employer reference, or any other person or organization, including record custodians, both collectively and individually 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 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.
*
Yes
No
I have carefully read the foregoing release and know the contents thereof and I sign this release of my own free act. This is a legally binding agreement which I have read and understand.
*
Yes
No
Thank you for your interest in being a part of the RFK Team!
By submitting this form and typing your name below, you give us permission to contact your references and begin the screening process. Once your application is received and reviewed, you will receive a link to our online background check form from Sterling Volunteers.
Electronic Signature (your full name)
*
If under the age of 18, parent or guardian electronic signature (full name)
Submit
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