Summer Staff Application 2018
For any questions regarding this application:
Phone: 276-328-6876 (office) 1-800-359-4049 (toll free)
Email: info@campbethel.com
Your Full Name *
First Middle Last
Date *
Date of Birth *
Age *
Gender *
Permanent Address *
City *
State *
Zip
Preferred Mailing Address *
City *
State *
Zip *
Cell Phone *
Email *
EDUCATION INFORMATION
Choose which grade will be completed by June 2018
High School
Clear selection
College
Clear selection
Post Grad
Clear selection
GPA *
School / Dates Attended / Major / Degree (if applicable) *
School / Dates Attended / Major / Degree (if applicable)
MEDICAL INFORMATION
**Your insurance will be considered primary and Camp Bethel's will be secondary (only in applicable situations)
Insurance Company *
Address *
City *
State *
Zip *
Name of Policy Holder *
Policy # *
Group # *
Phone *
In case of emergency, please notify *
Relationship *
Phone *
OR Notify *
Relationship *
Phone *
Please list any current medications
Please list any allergies
Please list HEALTH RELATED dietary needs
List any serious illnesses/ injuries/ surgeries you've had in the last 2 years
Do you have any medical/ physical restrictions that would limit your performance in the job for which you have applied? *
If yes, please specify
Do you (or anyone in your family) have a history of any of the following? (check all that apply) *
Required
List any other pre-existing conditions or other information
Are you prone to any of the following (check all that apply)
Have you ever received medical treatment for nervous breakdown or other mental health disorders? *
If yes, please specify
Have you receveied the MMR immunization? *
Have you receveied the Tetanus immunization ? *
Date of Tetanus
FAMILY BACKGROUND
Father/Guardian in Home
Name
Relationship
Father/Guardian's Occupation
Mother/Guardian in Home
Name
Relationship
Mother/ Guardian's Occupation
Are your parents/ guardians born again believers? *
Do they attend church reguarly? *
If yes, what denomination do they associate with?
CHRISTIAN FELLOWSHIP
Are you a member of a church? *
Name of Church
City, State
Pastor's Name
Name of church PRESENTLY attending
City, State
Pastor's Name
How often do you attend?
List any involvement in Christian organizations (FCA, Young life, etc.)
PERSONAL TESTIMONY
**THE FOLLOWING MUST BE COMPLETED BY THE APPLICANT
Describe how, when and where you accepted Jesus Christ as your personal Lord and Savior *
What steps would you use to lead a camper to Christ? *
Include Bible verses to support
BIBLE KNOWLEDGE
Using BIBLE VERSES as support and YOUR OWN WORDS, briefly describe the following subjects
The Trinity *
The Virgin Birth *
Death, Burial and Resurrection of Jesus *
Salvation *
Speaking in Tongues *
Explain what 2 Timothy 3:16 means *
Once you are saved, are you always saved or can you lose your salvation? *
PLEASE COMPLETE THE FOLLOWING PRAYERFULLY. WE WANT TO KNOW HOW YOU HONESTLY FEEL, NOT WHAT YOU THINK WE WANT TO HEAR
Why do you want to work at Camp Bethel? *
What struggles have you had since accepting the Lord as Savior? *
Describe your personal prayer time and Bible study *
Are you currently memorizing Scripture on a regular basis? *
Do you feel it is acceptable to date a non-Christian? *
What are your thoughts on the following?
Sex before marriage? *
Drugs/Tobacco (any form) *
Movies/ TV/ MTV *
Music (types you like/ dislike, etc.) *
Homosexuality *
PREVIOUS CAMP EXPERIENCE
Camp Name
Dates
Attended or Worked?
Positions/Duties
Camp Name
Dates
Attended or Worked?
Positions/Duties
PREVIOUS WORK EXPERIENCE
Employer *
Dates *
Address and Phone # *
Position/Duties *
Employer
Dates
Address and Phone #
Position/Duties
REFERENCES
These people need to be familiar with your character and qualifications. We may contact them. Your signature on the final page is your authorization for release of information to them.
Previous Employer *
Position *
Phone *
School Professional *
(teacher, counselor, etc.)
Position *
Phone *
Spiritual Reference *
(Pastor, Assistant Pastor, Youth Leaders, etc.)
Relationship *
Phone *
In what position(s) are you interested in serving? *
Mission Staff reserves the right to assign you to the position best suited for overall
Required
Please provide us with information on why you feel qualified to fill the positions checked. *
SKILLS
Please check all CURRENT certifications held (must be up to date)
Do you have any musical talent? *
Required
If instrumental, what instrument?
Can you swim? *
CLASSES
Cabin Leader age staff will be asked to teach or assist in the recreation classes listed below. To let us know how you can help, please choose either teach, assist or interest.
Archery
Clear selection
Drama
Clear selection
Mountain Boarding
Clear selection
Rock Climbing
Clear selection
Softball/Baseball
Clear selection
Arts and Crafts
Clear selection
Flag Football
Clear selection
Musical/Vocal
Clear selection
Ropes Course
Clear selection
Swimming
Clear selection
Basketball
Clear selection
Media
Clear selection
Paintball
Clear selection
Skateboarding
Clear selection
Volleyball
Clear selection
Canoeing
Clear selection
Mountain Biking
Clear selection
Riflery
Clear selection
Soccer
Clear selection
Wilderness Survival
Clear selection
If you circled teach, please state your qualifications to teach that class
STATEMENT OF FAITH
Camp Bethel believes:
- In the entire Bible as the inspired Word of God

- In the one triune God - Father, Son, and Holy Spirit

- That man is totally depraved and in need of salvation

- That salvation is by grace through faith, and is made possible because of the virgin birth, death, burial, and bodily resurrection, and ascension of Christ Jesus

- That the Holy Spirit indwells in each believer, and that the believer's life is to be yielded to Him

- That the believer is kept by the power of God and thus is secure in Christ now and for eternity

- In eternal life with God for the saved and eternal punishment in hell for all who reject Jesus Christ

- In the personal, imminent return of our Lord and Savior Jesus Christ
I have read and agree with the Camp Bethel Ministries Statement of Faith
Signature / Date (Type Below)
I have read and DO NOT agree with the Camp Bethel Ministries Statement of Faith
Signature / Date (Type Below)
Please state the reason for your disagreement here
Summer Commitment
All summer staff members are required to attend orientation unless other arrangements have been made with the camp director. Orientation is especially important for potential cabin leaders. Please check all dates you will be able to serve this summer. (If you work less than 5 weeks, you will be considered a volunteer).
*
*Additional weeks to serve available
Required
Weekends off begin Saturday after all work is completed and end on Sunday at 5:00PM. Any change in time of departure or return must be approved by the camp director. You are allowed two weekends off. Please list below the weekends you will be requesting off (subject to approval).
Please read and initial each statement
I am willing to serve wherever I am assigned and I am willing to perform all assigned tasks, regardless of how insignificant they seem, to the best of my ability.
I am willing to actively and enthusiastically support all of the programmed activities, including but not limited to team games and competition, skits, morning exercises, etc.
If accepted for a position, I will follow all rules and regulations of the camp, as listed in the staff manual. I understand that failure to abide by the rules may result in my immediate dismissal.
I am willing to submit to those in authority over me, including my peers that may be placed in authority over me.
I agree to submit to a drug test if needed.
I commit to work the entire summer, with the exception of approved time away at the discretion of the Camp Director.
For applicants under 18 years of age
Parents please read the following before signing: The health information and history is correct as far as I know and the above applicant has my permission to engage in all prescribed camp/staff activities. If I cannot be reached in an emergency, I hereby give permission to Camp Bethel to secure proper medical treatment. I have read the application, I agree to the background check if needed.
Signature / Date
All other applicants
I verify that the information provided on this application is true and correct to the best of my knowledge. I understand that I will be working under supervision of the Camp Bethel Staff and I am subject to the rules and regulations of the camp. I promise to obey all of the Camp Bethel rules, day and night, and I understand that I will be sent home if I fail to do so.
Signature / Date
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