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Camp Surrey Staff Registration
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Step
1
of 4
All staff members must be at least 13 years old at the time of camp, will you be at least 13 years old at the time of camp?
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Yes
Staff First Name
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Staff Last Name
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Do you go by a different name? If yes, please let us know.
What age group will you be in on June 1st, 2024?
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13 - 17
18+
Gender
Select One
Female
Male
Email
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Email
Confirm Email
Phone
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Can you receive text messages?
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Yes
No
Address
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Address Line 1
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Shirt Size
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Select Shirt Size
Youth X-Large
Adult Small
Adult Medium
Adult Large
Adult X-Large
Adult XX-Large
Adult 3X-Large
Many staff positions require staff to be present through the duration of Camp. This includes Wednesday, Thursday, and Friday from 8:00am to 5:30pm, and Saturday from 10:00am to 3:00pm. Please select all days you will be available so we can find the best staff position for you!
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I'm available for the entire camp (Wed - Sat)
Wednesday
Thursday
Friday
Saturday
Other, please write your availability below.
Comments
Do you have specialized training? (i.e. current CPR, First Aid, Lifeguard, Counselor, etc.)
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Yes
No
Special training explanation
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Have you been to Camp Surrey before?
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Yes
No
In what capacity did you previously serve at Camp Surrey?
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Next
Staff Medical Release & Permission
As a staff candidate, by my dated initials and signature below, I certify the statements and information provided in items 1 through 6 that appear below:
1. ACCEPTANCE OF CAMP CONDITIONS: I understand and agree to the condition of the event venue as described in the information provided at GCSURREYHILLS.ORG/CampSurrey. I agree to participate under these conditions, including Photo/Video Release, Camp Surrey Standards Agreement, schedule of activities, and material to be presented.
2. DISCLOSURE OF SPECIAL HEALTH CONDITIONS: The following is the list of my special health conditions and needs, which event staff needs to be aware of:
Do you have any known special health conditions and/or allergies that the Camp Surrey Staff should be aware of?
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Yes
No
Special health conditions/allergies explanation
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Do you require any special needs/assistance?
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Yes
No
Special needs/assistance explanation
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3. RELEASE OF LIABILITY REGARDING SPECIAL HEALTH CONDITIONS: I submit that the above mentioned special health conditions and instructions are needed for myself while at the event. I understand that, although event personnel will seek to help accommodate these special conditions, nonetheless, by attending the event with these special health conditions:
By initialing, I understand the event is not equipped to monitor or supervise such special conditions or needs.
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By initialing, I certify it is safe for myself to participate in all event activities notwithstanding the special conditions, and notwithstanding any possible lapse in medication, or possible interaction with other people or circumstances that may affect the special conditions.
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By initialing, I release and indenify the event from all claims and liability stemming from the special conditions, including, without limitation, any claim, illness, or injury, resulting from the event's failure to recognize a situation which might be potentially harmful to a person with the special conditions, or failure to recognize the onset of an episode of the special conditions.
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4. PERMISSION TO SECURE EMERGENCY SERVICES: I give permission to event staff to secure usual and customary medical and/or legal services for myself if needed in an emergency circumstance at the event. I understand that I will be responsible for the costs of such services if not covered by my insurance.
Emergency Contact Information
Please enter the name of the parent or guardian who should be contacted in the case of an emergency.
Emergency Contact Name #1
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First
Last
Emergency Contact #1 Phone
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Emergency Contact Name #2
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First
Last
Emergency Contact #2 Phone
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Questions or Comments
Next
Staff Personal References
It is our desire to provide the absolute best experience and safe environment for the participants at Camp Surrey. Part of our process to ensure this desire is to select staff to serve at camp who exemplify great character and a heart to serve. In being a part of our volunteer staff team, it is imperative that our staff have characteristics of a servant, team-based, being able to work in fast-paced environments, and being willing to do a variety of tasks that may or may not be in any particular job description with a great attitude. It's this kind of mentality that promotes the culture at camp. In helping us to get to know you better, all volunteer staff applicant ages 18 and above must provide 2 references of individuals who know you personally, your character, and work ethic that Camp Surrey/Grace Communion Surrey Hills leadership may contact. References MUST NOT be related to you.
Reference #1
Reference #1 Name
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First
Last
Reference #1 Relationship to candidate
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Reference #1 Email
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Reference #1 Phone
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Reference #1 Questions or Comments
Reference #2
Reference #2 Name
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First
Last
Reference #2 Relationship to candidate
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Reference #2 Email
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Reference #2 Phone
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Reference #2 Questions or Comments
Staff Background Check
In addition to giving 2 personal references, ALL staff members ages 18 and over MUST have on file with Grace Communion Surrey Hills (GC Surrey Hills) a current and cleared background check that is initiated by GC Surrey Hills. Once you have completed the Camp Surrey Staff Registration application, a member of Camp Surrey/GC Surrey Hills will be in contact with you to initiate the background check. *All background checks are kept confidential and inaccessible by any person not part of the Pastoral Team.
Next
Required Acknowledgement of Agreements
PLEASE NOTE: To read all agreements before initialing, go to gcsurreyhills.org/campsurrey/camper-agreements.
By initialing, you are stating that you have read and agree to the Camp Surrey Standards Agreement
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By initialing, you are stating that you have read and agree to the Camp Surrey Photo/Video Agreement
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By initialing, you are stating that you have read and agree to the Camp Surrey Medical Release/Parental Permission Form
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By initialing, you are stating that you have read and agree to the Camp Surrey Climbing Wall Release & Waver Form
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Volunteer Staff Applicant Signature
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Clear Signature
Today's Date
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Submit