2014 CROSS POINT CAMP
Adult Leader Application
Name: ______/ (Circle one) Clergy / LaityCurrent Church: ______/ Email: ______
Home Phone: ______/ Cell/Mobile: ______
Address: ______/ City/State/Zip: ______
Vocation______
T-Shirt size: [S] [M] [L] [XL] [XXL] [XXXL] How do you prefer to be contacted: ______
Is this your first time working CROSS POINT? YES NO
Tell us why you would like to volunteer for CROSS POINT camp: ______
______
Indicate age groups with which you would prefer or have experience working with:
7th Grade8th Grade
9th Grade / PreferExperience
/ 10th Grade
11th Grade
12th Grade
Graduates / PreferExperience
Do you have training/experience working with youth who have special needs? YES NO
If "yes", describe: ______
______
What experience or training have you had in working with youth? ______
Are there hobbies, interests, skills, etc you could contribute that you feel would be helpful?
Describe: ______
The following are REQUIRED for adults working Cross Point Camp
Have you read and agreed to the Leader's Covenant and Medical Liability andRelease Form for the present camp? / YES NO
Have you had a background check with our conference office? If "yes" when? ______Note: Only valid if completed 2009 & 2011-2013 / YES NO
Have you completed and turned in a Challenge Course Form?
Payment and Registration Information: Total cost of adult leaders: $130 / YES NO
Make checks payable to “LDUMC”
Checks must accompany Camp Registration Forms
CROSS POINT Registrar
P.O. Box 6886
Lawton, OK 73506-0886
CROSS POINT CAMP LEADER’S COVENANT
I understand that in every activity at camp I am expected to keep the highest Christian standards of conduct. This includes, but is not limited to, the following Guidelines:
1.The use of or possession of illegal drugs, weapons, alcohol, tobacco products, or fireworks is prohibited. Violation of this will result in being sent home.
2.All conduct shall be in keeping with the highest Christian regard and respect for all people.
3.Everyone will participate in all group activities, as able.
4.All dress shall be modest and in good taste and appropriate for a Christian witness, i.e. no clothing with vulgarity, beer or tobacco advertising, underwear showing, short shorts, bare midriffs, or the like.
5.The areas used for all activities shall be left clean and free of litter, graffiti and the like.
6.Adults are role models and should not encourage or condone bad behavior or pranking.
In addition, the camp staff has permission to take my photograph/video and use as appropriate:
I have read and understand the Cross Point Camp Covenant above. I agree to abide by it and other Oklahoma Conference and Camps bylaws and regulations.
Signature______Date______
Medical Liability and ReleaseForm
I agree to hold the Oklahoma Conference Camping program leadership team and the leaders free from liability for injuries, damages, or losses unless caused by willful or intentional misconduct or neglect on the part of the leadership team leaders or camp staff. I give permission to the camp staff to seek medical attention as needed.
Name______(Please Print)
Health Insurance Company and Policy# ______
Known Existing Medical Conditions ______
Known Allergies ______
Do you require: Medical diet? YES NO
Vegetarian diet? YES NO
Note:ALL medications (Prescription and Non-prescription) must be checked in and kept in the
Nurse Station. Medications you will be bringing to camp: ______
______Pharmacy: ______Phone number: ______
Physician: ______Phone number: ______
Emergency Contacts:
1.______Relationship: ______Phone: ______
2.______Relationship: ______Phone: ______