Camp Cook Staff Application

Name

Please include maiden name and any alias names you may go by.

First Name

Last Name

Date of Birth

YYYY

Gender

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Church Affiliation

T-Shirt Size

For Staff Shirts

Children Eligible for Daycare

Please list the name and age of each child eligible for Daycare Program. Camp Ao-Wa-Kiya’s Daycare Program is limited to children who are 4-10 years of age. We ask that you make other arrangements for children who will not be campers or be eligible to serve as Junior Staff.

Skills/Certifications

Please mark the following that you have current certifications in:

Lifeguard

Lifeguard Trainer

CPR/AED

First Aid

CDL

Previous Food Program Experiences

As full-time camp cook for this summer season you will manage volunteer crews to help serve food during our summer camp weeks. Please list and describe your previous food program experiences.

Reference 1

Reference 1 Name

First Name

Last Name

Reference 1 Relationship (Non-Relative)

Reference 1 Email

Reference 1 Phone

(###)

###

####

Years Known Reference 1

Reference 2

Reference 2 Name

First Name

Last Name

Reference 2 Relationship (Non-Relative)

Reference 2 Email

Reference 2 Phone

(###)

###

####

Years Known Reference 2

Reference 3

Reference 3 Name

First Name

Last Name

Reference 3 Relationship (Non-Relative)

Reference 3 Email

Reference 3 Phone

(###)

###

####

Years Known Reference 3

Your Salvation Experience

Your Relationship to God

Your Church Attendance

Been Convicted of a Crime (Other than Minor Traffic Violations)?

If Yes, Explain:

Do You Have Any Physical Limitations

Do You Have Any Communicable Diseases?

If Yes, Please Explain:

Staff Agreement

Realizing the great responsibility and opportunity of working with children at Camp Ao-Wa-Kiya, I agree to: Sacrifice personal desires in the interest of the campers; Cooperate with the directory and other leaders under whom I serve; Obey camp and staff regulations printed in the staff manual; Endeavor to be a blessing to the campers with whom I work by helping to enrich their lives spiritually, physically, and mentally; and Uphold the standards and doctrinal position of Camp Ao-Wa-kiya (a copy of the doctrinal statement may be obtained at ao-wa-kiya.org). I hereby release and agree to hold harmless from liability any person or organization, whether listed or not, who provides information or references about me to Camp Ao-Wa-Kiya. I waive any right I might have to inspect references provided on my behalf. I certify that I have neither been convicted of, nor am I the subject of pending charges, for any offence involving actual or attempted child abuse or sexual molestation in any jurisdiction. If you agree, write your full name below.