Microsoft Word - 2024 CLBC Staff app.doc

Cocolalla Lake Bible Camp

PO Box 106

Cocolalla, ID 83813

(208) 263-3912

www.clbcamp.org

Dear Potential Staff Member,

Summer is just around the corner! This means that the staff at Cocolalla Lake Bible Camp is gearing up

for the summer. We are eager to see how God is going to work this summer as the Gospel of Jesus

Christ is proclaimed.

We are excited that you desire to serve this summer at Camp. We are in need of many helpers, and

everyone who helps has the privilege of being a part of God’s work at Cocolalla. Attached are the Staff

Application and reference forms. Please fill these out completely. You will need three references, one

being from your pastor/elder, and one from your Youth Leadership Leader . Please have your

references return their forms to Cocolalla Lake Bible Camp (address below) before June 1st. This

application also needs to be returned to the camp by June 1st. After we have received all of your

paperwork, we will contact you with information about Staff Training.

Notice:

1. All four weeks of camp starts on Mondays.

2. 7-8 Camp is a day shorter than 9-10 and 11-12 camps, being Monday-Thursday.

3. Each Monday of camp, there will be an all-staff meeting at 2:00pm before registration starts.

Please look at the dates below so you can decide when you would like to serve this summer. If you

have any questions, please call the Camp (208-263-3912). We look forward to serving with you this

summer!

Your fellow servants of the Gospel,

Dirk Darrow and Tim Coleston

Dates

June 1st Return Staff Application

May 31-June 1 Workdays Retreat (Starts at 6pm, and ends at 4pm on the 1st)

June 24 Wrangler Training (Starts at 9:45am)

June 24-28 Staff Training (Starts at 5:00pm on the 24

th

, ends at 2pm on the 28

th

)

July 8-13 Teen Camp (Staff meeting 2pm on the 8

th

, and leave at 4pm on the 13

th

)

July 15-19 11 & 12 Camp (Staff meeting 2pm on the 15

th

, and leave at 4pm on the 19

th

)

July 22-26 9 & 10 Camp (Staff meeting 2pm on the 22

th

, and leave at 4pm on the 26

th

)

July 29-Aug. 1 7 & 8 Camp (Staff meeting 2pm on the 29

th

, and leave at 4pm on the 1

st

)

Aug. 1-2 Staff R&R (Begins at 4pm on the 1

st

, and ends at 10am on the 2

nd

).

Cocolalla Lake Bible Camp ● PO Box 106, Cocolalla, ID 83813 ● 208-263-3912 ● www.clbcamp.org

Cocolalla Lake

Bible Camp

STAFF APPLICATION FORM

Name: _______________________________________ Age: ______ Phone#: ____________

Mailing Address: _____________________________________________________________

Email: _________________________ __________ Birth date: ________________________

Occupation: ________________________________ Education Level: __________________

Church: ___________________________________ Pastor: __________________________

Are you a member of this church? _______________ How long have you attended? ________

T-Shirt Size:

XS S M L XL XXL

Involvement with a Youth Leadership group that partners with CLBC is required. (18 and under)

Which Youth Leadership group have you been attending?____________________________

What has been your previous kid’s camp experience? ________________________________

___________________________________________________________________________

Please describe your personal testimony of Jesus Christ. ______________________________

___________________________________________________________________________

Why do you want to volunteer at Cocolalla lake Bible Camp?___________________________

___________________________________________________________________________

Please check which camps you would prefer to work at:

Teen Camp 11&12 Camp 9&10 Camp 7&8 Camp

Are you skilled in any of the following?– Horse wrangling, Lifeguarding, Video production,

Mountain Biking, Please describe:_______________________________________________

Have you ever been investigated for, charged with, or convicted of an offense involving child

abuse, sexual abuse, and/or substance abuse? _____________________________________

If yes, how recent was the offense? _______________________________________________

-and- what were the results of the investigation and/or charges? ________________________

___________________________________________________________________________

REFERENCES: Please list three adults (not relatives) who can speak of your responsibility,

faith, experience, and character. Your Pastor/Elder and Youth Leadership Leader should be

included. Please also ask your Parents to fill out the fourth reference form. If they would rather,

they can email us at [email protected] and we will send them a link to fill out a reference

form online instead of the paper forms attached.

1. Name _____________________________________________ Phone _______________

Address ________________________________________________________________

Email_______________________________ Relation ____________________________

2. Name _____________________________________________ Phone _______________

Address ________________________________________________________________

Email_______________________________ Relation ____________________________

3. Name _____________________________________________ Phone _______________

Address ________________________________________________________________

Email_______________________________ Relation ____________________________

Four personal reference forms have been included. Please hand them to your references with a

stamped envelope addressed to Cocolalla Lake Bible Camp, P.O. Box 106, Cocolalla ID

83813.

_______________________________________________________ Date ________________

Applicant Signature

_______________________________________________________ Date ________________

Parent Signature (if under 18)

Cocolalla Lake Bible Camp is affiliated with InFaith

Child Abuse Responsibility

Child abuse is as old as the history of mankind. It has many ugly forms and is a problem of severe magnitude and

shocking implications. The spiritual atmosphere which Cocolalla Lake Bible Camp (CLBC) attempts to provide may

be one of the best deterrents possible. When, however, an instance of child abuse is suspected or reported, our

leadership must do everything it can to help those in need as quickly as possible along the best spiritual and

professional guidelines. The CLBC Board of Trustees has prepared and adopted the “Child and Youth Abuse

Prevention Program for Cocolalla Lake Bible Camp” which is available in the CLBC office for your review. Any

volunteer, prior to receiving authorization from CLBC to serve in the volunteer capacity, must review and agree to

comply with the information contained in the aforementioned prevention program. If there is any suspicion of child

abuse in any form, it must be reported to the Executive Director, the Assistant Director or any senior leadership

person affiliated with Cocolalla Lake Bible Camp in compliance with the prevention program guidelines. The CLBC

leadership will comply with the steps contained within the prevention program. I acknowledge my responsibility to be

careful and conscientious in reporting any suspicions to the Cocolalla Lake Bible Camp leadership staff.

Applicant’s Signature Date

Have you ever been convicted of any offense other than minor traffic violation? Yes_______No______

If yes, please provide details of the conviction (date, type of conviction, how it was resolved, etc.). Please use

additional paper if needed.

I have read and fully understand all questions requested in this application. I certify that all answers given by me are

true, accurate and complete. I understand that the completion and/or execution of this application does not insure

me a volunteer position, nor does it obligate me or the organization in any way. I fully understand that the omission

and/or misrepresentation of facts requested may be cause for immediate dismissal without prior notice. If accepted

for service, I agree to abide by all the rules and regulations of the InFaith. I have read, understand, and agree to the

above.

Applicant’s Signature Date

SS# Required for Background Check: ____________________

Statement of Faith

The ministry of Cocolalla Lake Bible Camp is built upon what we believe, and what we believe is based on the Word

of God and our personal faith in Jesus Christ. We hold to the great foundational truths of the historic Christian faith

held in common by like-minded evangelical Christians with whom we share both fellowship and the mission mandate.

We believe that there is one God, creator and

sustainer of the universe, existing in three persons:

Father, Son, and Holy Spirit.

We believe that the Bible is the verbally inspired

Word of God, is inerrant in the original manuscripts

and uniquely infallible, our only authority for faith

and practice.

We believe in the deity of our Lord Jesus Christ, in

His virgin birth, in His sinless life, in His miracles, in

His substitutionary sacrifice upon the cross, in His

bodily resurrection, in His victory over sin and His

enemy Satan, in His present exaltation at His

Father’s right hand, and in His personal return, at

any time, in power and great glory.

We believe in the fall and the lostness of man,

whose total depravity requires that he be

regenerated by the Holy Spirit for his salvation.

We believe that salvation consists of the

forgiveness of sins, the imputation of Christ’s

righteousness, and the gift of eternal life, received

by grace through faith alone, entirely apart from works.

We believe in the ministry of the Holy Spirit by

whose indwelling the Christian is enabled to live a

godly life, and by whom the Church, the Body of

Christ, is gifted and equipped to serve and glorify

God.

We believe in the bodily resurrection of all mankind:

those who have trusted in Christ, the ultimate

Judge, will receive everlasting life and blessedness

in heaven; those who have not will receive

everlasting punishment and separation from the

presence of God.

We believe that Christ has commanded His Church

to preach the gospel to all people, and that this

mandate should be a primary concern of all

Christians. I hereby express my agreement with the above

Statement of Faith, and declare that all answers on

previous pages are correct to the best of my knowledge.

Applicant’s Signature____________________________

Date___ ____________

National Criminal Background Check

Cocolalla Lake Bible Camp

The following information will be used to conduct a national criminal

background check. By providing this information you consent to this

review of your background and understand that Cocolalla Lake Bible

Camp Inc. may deny you to serve as a volunteer or employee of the church without cause or

disclosure of reason.

Candidate Information

Last Name: ___________________________ First Name: ______________________ M:____

Social Security #: ________________ Driver’s License #: ____________________________

______________________________________________

Sex: ________ Date of Birth: ___________ (mm/dd/yyyy)

Street Address: ____________________________ Apt. # ____________________________

City/ST/Zip: ____________________________________ ____________________________

Phone #: ______________________________________

The above information and the resulting report are CONFIDENTIAL and shall only be disclosed

to authorize personnel.

COCOLALLA LAKE BIBLE CAMP INC. (“the Company”) may obtain information about you for employment purposes from a third party

consumer reporting agency. Thus, you may be the subject of a “consumer report” and/or an “investigative consumer report” which may include

information about your character, general reputation, personal characteristics, and/or mode of living, and which can involve personal interviews

with sources such as your neighbors, friends, or associates. These reports may contain information regarding your credit history, criminal history,

social security verification, motor vehicle records (“driving records”), verification of your education or employment history, or other background

checks. Credit history will only be requested where such information is related to the duties and responsibilities of the position for which you are

applying. You have the right, upon written request made within a reasonable time after receipt of this notice, to request disclosure of the nature

and scope of any investigative consumer report and a copy of any report about you. Please be advised that the nature and scope of the most

common form of investigative consumer report obtained with regard to applicants for employment and voluntary service is an investigation into

your education and/or employment history conducted by First Advantage Background Services Corp. ("First Advantage"), P.O. Box 105292,

Atlanta, GA 30348,1 -800-845-6004. The scope of this notice and authorization is all-encompassing, however, allowing the Company to obtain

from any outside organization all manner of consumer reports and investigative consumer reports now and throughout the course of your

employment and voluntary service to the extent permitted by law. As a result, you should carefully consider whether to exercise your right to

request disclosure of the nature and scope of any investigative consumer report.

ACKNOWLEDGMENT AND AUTHORIZATION I acknowledge receipt of the DISCLOSURE REGARDING BACKGROUND INVESTIGATION and

A SUMMARY OF YOUR RIGHTS UNDER THE FAIR CREDIT REPORTING ACT and certify that I have read and understand both of those

documents. I hereby authorize the obtaining of “consumer reports” and/or “investigative consumer reports” by the Company at any time after

receipt of this authorization and throughout my employment, if applicable. To this end, I hereby authorize, without reservation, any law

enforcement agency, administrator, state or federal agency, institution, school or university (public or private), information service bureau,

employer, or insurance company to furnish any and all background information requested by First Advantage P.O. Box 105292 Atlanta, GA

30348, 1 -800-845-6004, another outside organization acting on behalf of the Company, and/or the Company itself. Their Privacy Policy can be

reviewed at http://www.fadv.com/privacy-policy/. I agree that a facsimile (“fax”), electronic or photographic copy of this Authorization shall be as

valid as the original.

Signature: __________________ Date: _____________________

Print Name: ______________________ _____________________

Cocolalla Lake

Bible Camp

STAFF HEALTH FORM

Name: _______________________________________________ Date: _________________

Age: _________________ Home Phone #: ________________________________________

Emergency Contact: __________________________________________________________

Phone: ____________________________________ Relation: _________________________

Please list all food allergies: _____________________________________________________

Please list all medical allergies: __________________________________________________

What past or present illness(es) or condition(s) should the CLBC medical staff know about? __

___________________________________________________________________________

Date of last Physical exam: ____________________ Tetanus shot: ____________________

Family Insurance ____________________________ Policy Number: ____________________

Staff Member signature _______________________________________________________

IMPORTANT! For Staff under 18 years old:

IN CASE OF EMERGENCY, I understand that after every effort is made to contact me and I can’t

be reached, I hereby give permission to the physician selected by the camp director or nurse to

hospitalize secure proper treatment, and to order injection, anesthesia or surgery for my child, as

named herein.

Parent/Guardian Signature ____________________________________________________

Date: ___________________________ Phone: ____________________________________

Please fill out this form to the best of your knowledge. Because this reference is used for both acceptance

and development, it is most valuable when filled out objectively. Please avoid the temptation to make the

applicant appear perfect.

To request the online version of this reference (Google Forms), please email Tim at reference@clbcamp.org.

Name of Potential Staff ________________________________________________________

Name of Referee: _________________________________ Position: ___________________

Address ____________________________________________________________________

Phone: ____________________ Date: ___________________________

How long have you known this person? ___________________________________________

In what capacity? ____________________________________________________________

How closely have you interacted with the volunteer? Please check the box(s) that apply or write

a more detailed description below.

One on One Small Group Casual Relationship

CHARACTER

(Please check the boxes that you feel apply to the applicant. Please explain if needed.)

0=I have not observed the applicant in this area

1=The applicant is weak in this area

2=The applicant is lacking in this area but knows it and desires to grow

3= The applicant is usually decent in this area, but occasionally struggles

4=The applicant does a good job in this area

5=The applicant is outstanding in this area, and this quality stands out

0 1 2 3 4 5

Teachable __________________________

Servant’s Attitude __________________________

Concern for lost __________________________

Knowing God’s Word __________________________

Handling God’s Word __________________________

Self-disciplined __________________________

Responsible __________________________

Submissive to Authority __________________________

Leadership Ability __________________________

Flexible __________________________

COCOLALLA LAKE BIBLE CAMP

REFERENCE FORM

SHORT ANSWER

How does the applicant act around his/her peers?___________________________________

___________________________________________________________________________

Is the applicant discerning in his/her use of humor?__________________________________

___________________________________________________________________________

How did the applicant do in their Bible reading, prayer, and church involvement this year in YL?

(for Youth Leadership Leaders)_________________________________________________

__________________________________________________________________________

Can you comment on the applicant’s punctuality?____________________________________

___________________________________________________________________________

LONG ANSWER

Based on your knowledge of the applicant, what areas do they most need encouragement,

discipleship, or correction?_____________________________________________________

___________________________________________________________________________

Would you trust the applicant to lead and disciple your children? If no, please explain._______

___________________________________________________________________________

Please comment on the applicant’s commitment to right living, i.e., consistent Christian

testimony, morality, and honesty. _________________________________________________

___________________________________________________________________________

Is there anything in the applicant’s life that would cause you not to recommend them for service

at camp? If yes, please explain. _________________________________________________

___________________________________________________________________________

Is there anything else (good or bad) you feel would be helpful for us to know if we serve

alongside the applicant this summer? If yes, please explain.____________________________

___________________________________________________________________________

Signature:_________________________________________________ Date:_____________

Please send back to:

(208) 263-3912 * Cocolalla Lake Bible Camp * P.O.Box 106 * Cocolalla ID 83813

Please fill out this form to the best of your knowledge. Because this reference is used for both acceptance

and development, it is most valuable when filled out objectively. Please avoid the temptation to make the

applicant appear perfect.

To request the online version of this reference (Google Forms), please email Tim at referen[email protected].

Name of Potential Staff ________________________________________________________

Name of Referee: _________________________________ Position: ___________________

Address ____________________________________________________________________

Phone: ____________________ Date: ___________________________

How long have you known this person? ___________________________________________

In what capacity? ____________________________________________________________

How closely have you interacted with the volunteer? Please check the box(s) that apply or write

a more detailed description below.

One on One Small Group Casual Relationship

CHARACTER

(Please check the boxes that you feel apply to the applicant. Please explain if needed.)

0=I have not observed the applicant in this area

1=The applicant is weak in this area

2=The applicant is lacking in this area but knows it and desires to grow

3= The applicant is usually decent in this area, but occasionally struggles

4=The applicant does a good job in this area

5=The applicant is outstanding in this area, and this quality stands out

0 1 2 3 4 5

Teachable __________________________

Servant’s Attitude __________________________

Concern for lost __________________________

Knowing God’s Word __________________________

Handling God’s Word __________________________

Self-disciplined __________________________

Responsible __________________________

Submissive to Authority __________________________

Leadership Ability __________________________

Flexible __________________________

COCOLALLA LAKE BIBLE CAMP

REFERENCE FORM