Camp Bethel Adult Volunteer Printable Application

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Camp Bethel Adult Volunteer Application 2007

Complete this application legibly including complete addresses and phone numbers for your three references.

Upon completion, return application and forms to:

SUSAN CHAPMAN (Program Director), CAMP BETHEL, 328 BETHEL ROAD, FINCASTLE, VIRGINIA 24090

(or email numbered answers to camp_bethel@yahoo.com)

Date of application: ___________________

1. Full name: ________________________________________

2. Position applying for:

3. Social Security Number: __________-_______-____________

4. Your e-mail: ________________________________________

5. DOB (month/day/year): ______/______/______; AGE on June 17, 2007: ________

6. Home Mailing Address (number and street or PO Box, city, state, zip): __________________________________________________________________________________

7. Home phone: (_____) _______-___________; Cell phone: (_____) _______-____________

(#’s 8-18: Use extra paper for expanded responses, if needed.)

8. List your previous camping experiences (include name of camp, your position, dates there, location, highlights) :

9. List your related work/volunteer or leadership experiences (include name of institution, position, duration/dates, location and description of duties):

10. Why do you wish to spend a week working in a Christian resident camp with children and youth?

11. Are you a member of a church? If yes, include the church name, denomination and location of church.

12. Briefly describe your faith journey. Include details about your personal devotional life, your involvement in Christian community, and your vision for your work towards Christian community at Camp Bethel.

13. Camp skills & activities: (Write #1 by those in which you can assist; #2 those you can lead for campers.)

Adventure/Trips:

__river canoeing

__backpacking

__mountain biking

__horseback riding

__high ropes

__white-water rafting

__caving

__other (explain)

Bethel Specific:

__family-style meals

__table settings

__farm/Heifer animals

__Bethel traditions

__Bethel & area history

__Brethren heritage

__other (explain).

Camp Skills:

__trail cooking

__tent camping

__lashing

__fire building

__woodcraft

__other (explain)

Counseling Pro:

__conflict resolution

__homesickness prevention

__behavior management;

__bedtime stories

__imagination games

__other (explain)

Faith development:

__Bible study

__devotions

__prayer

__faith-based skits

__interpret/apply scripture

__song leading

__musical instrument:______

__other (explain)

Nature Lore:

__Appalachian ecosystems

__astronomy

__trees/plants

__wildlife/birds

__pond/stream ecology

__geology/rocks

__other (explain).

On the Go/Activities:

__small group games

__large group games

__indoor games

__trail construct/maint.

__hiking

__challenge course

__other (explain)

Pool/Waterfront

__pond fishing

__creek exploring

__pool games

__swim lessons

__canoe strokes

__other (explain)

Site Work:

__mowing/trimming

__kitchen work/duties

__janitorial/housekeeping

__skilled labor (explain)

__other (explain).

14. What other skills or experiences do you have that could be useful at camp? (ie: sign language; Spanish; juggling; courses, etc.)

15. We strongly emphasize the following: Camp activities are focused in the outdoors (hiking, camp-outs, cook-outs, exploration, etc.) and involve direct interaction with our 470 acre natural setting. As a camp counselor, you will be expected to spend most of each week outdoors. Describe your comfort in the outdoors and your willingness to “get dirty” in order to give your campers an outdoor Christian experience.

16. Check and date those certifications below for which you will have a CURRENT card during the upcoming summer (through August 4).

___Red Cross Lifeguard Training, date: _______

___Red Cross WSI, date: ________

___Basic Canoeing, date: _______

___Red Cross First Aid, date: _________

___American Heart Assoc. First Aid, date: _____

___Red Cross CPR, date: ________

___American Heart Assoc. CPR, date: ________

___Wilderness First Responder, date: ________

___Wilderness First Aid, date: _____________

___other health/safety/activity cert: ________

17. HEALTH: Do you have any condition (physical, psychological or emotional) which might limit your full participation in this highly demanding summer position? ___no; ___yes (If yes, explain on a separate paper.)

18. VOLUNTARY DISCLOSURE: Have you been convicted of any crime, felony, child abuse, or sexual abuse? ____ (If yes to any, explain on separate paper.)

20. RECOMMENDATIONS: List names, phone numbers, and addresses of your three references.

1. Employer/Teacher: ___________________________________; phone: ____________________;

2. Character: __________________________________________; phone: ____________________;

3. Minister/Character: ___________________________________; phone: ____________________;

21. DATES AVAILABLE: Please check the ‘06 summer calendar and list the dates you are available to serve:

22. I, (print name) __________________________________, verify the information on this application and grant the Outdoor Ministries Committee of the Virlina District of the Church of the Brethren and Camp Bethel permission to perform a routine criminal background check and driver’s license investigation.

SIGNATURE: ___________________________________________, DATE: ________________________

Include with this application a photocopy or scan showing (if any) your driver’s license and any certification cards.

If you have any questions about the application process, call Susan or Barry at (540) 992-2940 or e-mail at camp.bethel@juno.com.

“Rules for acceptance and participation in Camp Bethel programs are the same for everyone regardless of race, color, national origin or sex.”