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 staff member for the Kearney Camp I have served at RFK Camps in other Cities or States

Current Drivers License Number (A photocopy of license must accompany application)*

Upload picture of your DL here:

Please also upload a current photo of yourself (headshot).

Gender

Male Female

Current Age*

Marital Status*

Street Address*

City, State, Zip*

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

Have you received certification in any of the following?

Do you have previous background or training in working with children who have been abused or neglected?

Yes No

If yes, in what way?

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

Do you have any medical, emotional, or mental health conditions?

No Yes

If yes, please describe:

Do you take any medications?

Yes No

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?

Yes No

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:

High School Name*

Date of Graduation*

College

College Major

Date of Graduation

Other Education

Reference #1 Name, Address, Phone, & Email

Reference #2 Name, Address, Phone, & Email

Reference #3 Name, Address, Phone, & Email

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*

How do you feel you would be best utilized at camp?

I would prefer my campers to be:

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?

Yes No

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.

No Yes

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

Camp Staff Application

Medical History

Education

Personal References* (required for first time staff only) No former employers or relatives.

Personal Profile

Thank you for your interest in being a part of the RFK Team!