Personal Information
Applicant's Name *
Applicant's Name
Birthdate *
Birthdate
Mailing Address *
Mailing Address
Home Phone *
Home Phone
Cell Phone *
Cell Phone
unisex: small - XXL
Employment Record
Education & Developmental Programs
Health Information
Applicant's Name *
Applicant's Name
Doctor's Phone *
Doctor's Phone
Next of Kin *
Next of Kin
Next of Kin Address *
Next of Kin Address
Next of Kin Home Phone *
Next of Kin Home Phone
Next of Kin Cell Phone
Next of Kin Cell Phone
Next of Kin Work Phone
Next of Kin Work Phone
Emergency Contact *
Emergency Contact
This should be someone different than the person named next of kin.
Emergency Contact Home Phone *
Emergency Contact Home Phone
Emergency Contact Cell Phone
Emergency Contact Cell Phone
Emergency Contact Work Phone
Emergency Contact Work Phone
Health History
Do you suffer from any medical/emotional condition that in any way restricts normal activities including land and water sports? *
Are you subject to any of the following? *
Have you been treated by a health care professional for any medical/emotional conditions in the past 12 months? *
Please list any allergies that you have. *
If you are not taking any medication, please write 'none'.
Are you on a special diet? *
I declare this health history to be accurate to my knowledge. I hereby give permission to the doctor/nurse selected by the camp to provide me with medical treatment in the case of an emergeny.
Signature *
Signature
Parent/guardian if applicant is under 18 years of age.
Date *
Date
Personal Questions
Apply for a Staff Position
Sr. Staff Positions (May 1 - Aug 23) - For more information on each position please visit our website.
*
Weeks Available *
Please check the weeks you are available to work.
Honorariums
Once you have been accepted for a position at camp, you will be given details about the honorarium that you may receive. (Jr. Cabin Leaders and City Day Camp Workers are not eligible to receive an honorarium)
Camp Skills
Please list the 4 skills that you are most interested in leading/helping with during the summer. If you rate yourself as ‘intermediate’ or ‘expert’ please provide an explanation of your previous experience.
References
All applicants need to provide the names of 1 Pastor/Mentor and 2 Adult Acquaintances over 25 years of age who have known you for at least 3 years and are not relatives. Redberry Bible Camp will send detailed reference forms directly to your reference using the emails that you provide for them. Please inform your references that they will be receiving a form from Redberry Bible Camp to fill out regarding your application.
Reference #1 Name *
Reference #1 Name
Reference #1 Phone *
Reference #1 Phone
Reference #2 *
Reference #2
Reference #2 Phone *
Reference #2 Phone
Reference #3 Name *
Reference #3 Name
Reference #3 Phone *
Reference #3 Phone
Authorization of the Applicant regarding Reference Forms *
Authorization of the Applicant regarding Reference Forms
I authorize the release of the disclosed information by the people completing character reference forms for the consideration of the applicant. I waive any right or privilege to inspect or challenge the contents of this form. I understand that the information will be held in confidence by RBC and will not be released to anyone (other than employees, agents, representatives, and/or professional advisors of RBC) without the permission of the person giving such character reference of in the absence of Court Order, Subpoena or laws requiring the disclosure of such information.
Date *
Date
Additional Questions
These questions are for specific positions. If you are not applying to these positions, please skip this section and move on to the 'Personal Evaluation' portion of the application.
Cook/Assistant Cook
If you are accepted into this position at camp, you will have to supply us with a copy of your certification.
Lifeguard/Assistant Lifeguard Questions
If you are accepted into this position at camp, you will have to supply us with a copy of your certification.
Wrangler Questions
Personal Evaluation
Please choose the statement that you believe best applies to you.
Personality *
Please check only those that apply to you. Please include negative characteristics - no one is perfect!
Signatures
In submitting this application I declare that all of the information is accurate to the best of my knowledge.
Applicant's Name *
Applicant's Name
Date *
Date