LAST NAME:

Youth Team 2014–Staff Application

Please complete this form and sign it to indicate you are volunteering to assist with the 2014 Youth Team – Camp Runnamucka! as an adult staff member. By signing you attest to the truth of all statements, agree to assist with camp activities, enforce camp rules and mentor the youth attending our camp.

A REQUIREDYouth Team retreat has been scheduled for June 22nd at Camp Rotary, prior to the campers arriving the next day. We will be providing training which should provide you with tools to fill your role. Additionally, we will take time to build our team of Adult Staff and Junior Counselors.

Thank you for volunteering for the 2014 Camp Runnamucka! Military KidsCamp Montana. Your time, talents and especially your dedication are appreciated.

Name:

(Last, First, MI)

Address:

City: State: Zip:

Phone: Age (Must be >20):

Email Address for camp information:

Would you like to help with the Junior Counselor Retreat 21/22 June 2014?

Special Licenses, certifications or skills:(bus or truck driver, CPR, Teacher Cert., etc.)

Questions:

  1. List your areas of expertise; skills which qualify you to be a staff member:
  1. Why do you wish to be a Youth Team Member?
  1. List the youth activities in which you have been involved(Especially those which demonstrate your mentorship abilities):
  1. List and explain any camp experience you have.
  1. Please list two referrals, with contact numbers.
  1. Do you agree not to be alone with any minors at any time during camp?
  1. Do you agree not to bring any alcoholic beverages or tobacco products into the campsite area?
  1. Do you recognize that my service at the 2014 youth camp is voluntary?
  1. Do you agree to attend the Youth Team retreat and read and respond to staff emails and notifications?
  1. Required criminal history information:
  • I have completed an FBI finger print background check as required. If no, please notify Sara Cease as soon as possible to obtain instructions to get the required check.

When:

  • Have you ever been arrested for or charged with a crime involving a child?
  • Have you ever been asked to resign because of or been decertified for a sexual offense? And if so, “provide a description of the case disposition.”

The MTNGCYP Youth Team will:

  1. Youth Team members will attend the Youth Team Retreat 22 June, 2014; exceptions must be approved ahead of time by the State Youth Coordinator, Sara Cease.
  1. Youth Team members will demonstrate respect and concern for the campers, JCs and other staff.
  1. Youth Team members will always show initiative in helping campers and encourage full participation by all campers in their cabin and all activities.
  1. Youth Team members will participate in staff meetings during camp.
  1. Youth Team members will mentor and seek the assistance of JCs as needed.
  1. Youth Team members will handle discipline in accordance with the camp discipline procedures.

YOUTH TEAM MEMBERS WILL SET AN EXAMPLE OF HIGH MORALS AND EXEMPLARY BEHAVIOR, INCLUDING DRESS AND LANGUAGE.

As a Youth Team member. I agree to abide by all rules, policies and regulations.

______

Applicant’s Signature Date

Please direct all questions to Sara Cease at 406-324-3925 or

Send the completed form to:

If you cannot digitally sign please also send signed copy to:

Sara Cease, Lead Child and Youth Program Coordinator

1956 Mt. Majo

Fort Harrison, MT 59636