Camp Staff Registration | Freedom Church

If you are a human and are seeing this field, please leave it blank.

Fields marked with an * are required

All staff must complete a registration form.

First Name *

Last Name *

Gender *

Male
Female

Name of the church you attend

Birthdate *

Email *

Address 1

City

Zip / Post Code

Phone

Emergency Phone Number 1 *

Emergency Phone Number 2 *

Area you would like to work at camp (kitchen, activities, cabin helper)

Medical Information

Family Physician *

Family Physician Phone Number

Does your family have health insurance?

Please bring a copy of your insurance card to check in or provide information below.

Insurance Company Name

Policy Number

Group Number

Please list any medical conditions the camp staff need to be aware of and/or comments

Special diet/food restrictions? *

If yes, please specify

Any Food or Drug Allergies? *

If yes, please specify (bee sting, food or medication allergy)

Release of Liability

I understand that if any accident should occur or any sickness, it is my own responsibility. It is understood that Freedom Church Youth Camp will not be held liable for any expense in such case. In case of emergency, I understand that EVERY effort will be made to contact the emergency contact listed on application. If said person cannot be reached, I hereby give permission to the physician to secure proper treatment, care, even hospitalization for said emergency. I also understand that ALL medications must be kept in a secure area out of the reach of campers.

I understand that by placing my name in the signature blanks below, I am agreeing to abide by all rules, policies and discipline of Freedom Church and the camp as set forth by the director and staff, and consent to the above stated information and release of liability.

Signature

Staff Commitment

Along with the leaders and other youth, I agree to conduct myself in a Christian manner, to represent Christ and provide a Christian example to the campers at all times. I promise to respect God, respect others, and respect property. I agree to strive to make each activity the best it can be for campers and staff. I will be an example in worship and by participating joyfully in all camp events. As a cabin leader, I will make myself available as a mentor to campers during activities, break out sessions and/or by praying with campers during altar call. By signing this consent, I am agreeing to abide by all rules, policies, and discipline of the Campground and camp as set forth by the Director. I understand that my agreement holds me responsible to these things and the consequences thereof.

Signature

STAFF REGISTRATION FORM