2024 Staff Registration

I would like to apply to serve at:

2024 Junior Camp (July 8-13) 2024 Senior Camp (Aug 5-10) Both

Name

Age

Birthdate

Sex

Male Female

Phone

This address will receive a confirmation email

Address

If you selected "other" because your church was not listed, please list the church and town here:

T-Shirt Size [Selected size may not be available if registering after June 17 (JR Camp) and July 15 (SR Camp).]

Youth: Small Youth: Medium Youth: Large Small Medium Large X-Large XX-Large XXX-Extra Large

How long have you known Christ as your Savior?

Please share a brief salvation testimony of how you came to faith in Christ as Savior.

List the states you have lived in the past 7 years:

Have you ever served at Camp Northwest before?

Yes No

How many years have you served at Camp Northwest?

In what way(s) did you serve in the past at Camp Northwest?

Counselor Assistant Counselor Kitchen Staff Team Leader Program Staff Church Sponsor (Church Registration)

Why do you want to serve at Camp Northwest?

I want to serve at camp as:

Counselor Assistant Counselor Kitchen Staff Camp Staff (Approved by Directors)

If you desire to counsel, what age group would you want to counsel: 2 - 4 grade (JR) 5 - 7 grade (JR) 6 - 8 grade (SR) 9 - 12 grade (SR) Any Grade

Are you certified in the following areas? First Aid CPR Lifeguard Nursing Aid Videography

List any special skills, sports played, instruments played, drama background, craft abilities, that you think could be an asset to Camp Northwest.

Qualifications for Counseling Staff *

1. For Junior Camp, you must be 16 years old to be a head counselor and 15 to be an assistant counselor.
2. For Senior Camp, you must be 20 years old to be a head counselor and at least 18 years old to be an assistant counselor.
* You be approved by your pastor and the administrative director of camp. Through a background check, information will be collected from various law enforcement agencies, courts, and correction agencies for the purpose of obtaining criminal history records or child abuse findings. All findings are on a case by case basis and Camp Northwest reserves the right to reject any applicant it finds not suitable to serve.

Afternoon Activity Preferences

Perspective counselors & assistant counselors, please fill out your afternoon activity preferences below and then hit the "submit" tab. Once you have completed this form, then finish the rest of the registration form below starting with the Medical Informtaion section. (PERSPECTIVE KITCHEN STAFF DO NOT NEED TO FILL OUT THIS AFTERNOON ACTIVITY PREFERENCE FORM.)

Qualifications for Kitchen Staff

1. You must be at least 15 years old to serve on the kitchen staff.
2. You must be able to stand on your feet for 5 to 8 hours a day.
3. You must be able to carry 15-20 lbs. of trays and/or food.
4. You must be able to function as a “team” player under the direction of the Kitchen Director.
5. You must be punctual for your work times and assignments.
6. You must be willing to follow instructions, even if you have done it another way before.
7. You must be able to smile under pressure and do your best.
Cost
There is no cost for those who are accepted and needed to fill a staff position. Occasionally, we fill all of the staff positions and a qualified staff person still would like to come and serve. In such cases, there is a $125 charge to help cover their cost to come for the week.

Kitchen Staff Job Preferences

Prospective kitchen staff, please fill out your job preference (1 - Highest / 4 - Least) below and then hit the "submit" tab. Once you have completed this form, then finish the rest of the registration form below starting with the Medical Informtaion section. (PERSPECTIVE COUNSELORS & ASSISTANT COUNSELORS DO NOT NEED TO FILL OUT THIS KITCHEN STAFF JOB PREFERENCES FORM.)

Medical Information

Primary Doctor's Name

Primary Doctor's Phone Number

Tetanus Booster Shot (If the shot is not up to date, one may be given if needed.)

List Allergies (Seasonal, Food, Medicines, Insects)

Pre-existing Medical Conditions (diabetes, asthma, heart problems, seizures, etc.)

Restricted Activities

Medication

MEDICATION POLICY:
Staff will be in charge of their own medication. Listing your medication is optional, but can be helpful if you have a medical emergency and you are unable to communicate the medication you are currently on. We encourage all prescription medication to be in the original container with the staff's name, name of medication, and directions clearly marked on the pharmacy label. Over-the-counter medication can only be provided by the camp nurse and staff. The camp nurse has non-prescription medicines in the event of a minor illness or injury.

1st Medication Name:

1st Medication Dosage:

1st Medication Frequency:

2nd Medication Name:

2nd Medication Dosage:

2nd Medication Frequency:

3rd Medication Name:

3rd Medication Dosage:

3rd Medication Frequency:

4th Medication Name:

4th Medication Frequency:

4th Medication Dosage:

Primary Medical Insurance

Insurance Company Name

Insurance Company's Phone Number

Policy Holder's Name

Policy ID #

Member ID #

Emergency Contact Information

Name of Emergency Contact

Relationship

Emergency Contact Phone Number

Other Emergency Contact Phone Number

Notice

These items are not allowed at camp: cell phones (unless given special permission), radios, CD or MP3 Players, hand-held video games, questionable magazines, tobacco, liquor, drugs, knives, guns, or fireworks. If a reasonable suspicion exists of a camper having any of these items, his/her backpack or luggage may be searched.

Doctrinal Statement Agreement

Doctrinal Statement (Please carefully read and agree to the following doctrinal statement.)

I am a born again believer and I believe . . .

1. the Old and New Testament Scriptures are verbally inspired of God and inerrant in the original writings, and that they are the supreme and final authority in faith and life.

2. in one God, eternal, omnipotent, omnipresent, omniscient, manifesting Himself in Three Persons--Father, Son, and Holy Spirit; one in nature, equal in attributes, power, and glory.

3. the Lord Jesus Christ was begotten by the Holy Spirit, born of the Virgin Mary, and that He is true God and true man.

4. God created man in His own image and in a state of innocency, but man willfully transgressed God's law and lost communion with God, becoming dead in sin, corrupt in nature, and incapable of pleasing God.

5. God has irrevocably ordained each person as a man or a woman. Marriage, which is the only appropriate place for sexual activity, can only be between one man and one woman.
6. the Lord Jesus Christ died for our sins according to the Scriptures as a representative and substitutionary sacrifice, and rose again for our justification; and all who believe in Him are justified on the ground of His shed blood and are saved by grace through faith wholly apart from human merit or works.

7. all who receive the Lord Jesus Christ by faith are born again by the Holy Spirit through the Word of God and thereby become the children of God, possessing eternal life.

8. in the resurrection of the crucified body of our Lord, in His ascension into Heaven, and in His present life there for us as High Priest and Advocate.

9. in the personal and visible pre-millennial return of our Lord and Savior, Jesus Christ, to reign upon the earth.

10. in the bodily resurrection of all the dead: the saved to a life of eternal glory and bliss in Heaven with God; the unsaved to eternal judgment of conscious suffering and woe in the lake of fire.

11. it is necessary to hold sound and aggressive scriptural convictions of separation from liberalism, apostasy, and compromise with unbelief.

Agree with Doctrinal Statement

Yes

Standards for Camp Northwest Staff

1. Must sign the doctrinal statement from conviction, not convenience.

2. Must maintain a maturing spiritual walk with God in order to be always ministering to the needs of others.

3. Must be faithful in daily personal devotions, spending time in Bible reading and prayer.

4. Must maintain a separated position from all worldly practice, in whole-hearted devotion to the cause of Christ, in a high standard of Christian conduct; since such separation, devotion, and standard is the only scriptural basis for a useful Christian life. For this reason we oppose all practices which hinder Christian growth and detract from Christian influence, such as: worldly music, smoking, drinking, drugs, filthy language.

5. Must reflect the testimony of Christ in personal appearance at all times.

6. Must love young people. Love is a self-sacrificing desire to meet the loved person’s needs.

7. Must maintain loyalty toward camp leaders. No griping; constructive suggestions welcomed.

8. Must be faithful, dependable, and responsible.

I have carefully read and agree to abide by the above standards during the time I am at Camp Northwest if I am offered a staff position.

Agree with Camp Standards

Yes

Commitment

As a counselor or kitchen worker, I will read the Staff Handbook before coming to camp. As a counselor, I will also read the Counselor Training Manual before coming to camp. As a staff volunteer, I agree to follow the policies and rules of Camp Northwest. I will not hold Camp Northwest or any church personnel responsible for the health of, or for any accident to myself. IN CASE OF EMERGENCY, I hereby give permission to the physician selected by the camp to hospitalize, secure proper treatment for, and to order injection, anesthesia, and/or surgery for myself. Your signature below also authorizes Camp Northwest and Criminal Information Services, Inc. to obtain information about you (if applicable) from various law enforcement agencies, courts, and corrections agencies.

Agree with Commitment

Yes

Type Name to Consent

Also Check Here to Consent

2024 Staff Registration

Description

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