Bridgeport Camp and Conference Center

Select the camps that you wish to volunteer for: *

Children's Music - June 12-16, 2012

Children's 1 - July 10-14, 2012

Children's 2 - July 17-21, 2012

Children's 3 - July 24-28, 2012

Children's 4 - August 7-11, 2012

Junior High 1 - June 18-23, 2012

Junior High 2 - June 25-30, 2012

Senior High - July 2-7, 2012

First Name *

Last Name *

Gender *

Male

Female

Date of Birth *

Current Age *

Primary Phone *

e-Mail *

Home Address *

Employer

Employer Address

Employer Phone

What church are you a member of? *

How long have you been a member of that church? *

Church Phone *

Please select the top TWO areas you have the most experience in:

Musical Instruments

Singing / Song Leading

Sports

Arts & Crafts

Drama

Leading Bible Studies

Recreation & Games

First Aid

CPR

Lifeguard

Other

Comments on the above selections?

Reference 1 - Minister *

Reference 1 - Minister's Phone *

Church Phone *

Reference 2 - Cannot be a family member *

Reference 2 - Relationship to You *

Reference 2 - Phone *

Reference 3 - Cannot be a family member *

Reference 3 - Relationship to You *

Reference 3 - Phone *

Have you read the Code of Conduct? *

Do you understand that the information that you have provided may be verified by contacting persons or organizations named in this application? *

Do you hereby release and agree to hold harmless from liability any person or organization that provides information concerning you to Bridgeport Camp & Conference Center of the North Texas Conference of the United Methodist Church? *

Do you hereby agree to obtain the required Background Check through the Safe Churches Project website if you have not had one performed in the last year? *

Do you understand the criminal history record, as received from the reporting agencies, may include data about arrests, convictions, plea bargains, and deferred adjudications? *

Do you understand that information from the criminal history record will be used, in part, to determine your eligibility for an employment/ volunteer position with this organization? *

Do you understand that as long as you remain a volunteer here, the criminal history records check may be repeated at any time? *

Do you understand that you will have an opportunity to review the criminal history, and that a procedure is available for clarification if you dispute the record as received? *

I do for myself, my heirs, executors and administrators, hereby remise, release and forever discharge and agree to indemnify the Safe Churches Project and each of their officers, directors, employees, and agents harmless from and against any and all: *

causes of actions, suits, liabilities, costs, and other expenses resulting from the investigation of my background in connection with my application to become a volunteer/staff member.

In submitting this application, do you swear or affirm that the information that you have given is true and correct? *

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