Thank you for having a heart to serve at CYC '23 and for your willingness to be a part of the team. Applications are open for the CYC 2023 camp season. 1Personal Information2Preferences and Skills3References4Questionnaire5Affirmation / Agreement / Liability 67 Volunteer/Staff Name* First Last Parent/Guardian NameIf under the age of 18. First Last Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Cell Phone*Home Phone*Gender* Male Female Marital Status* Single Married Birth Date* MM slash DD slash YYYY Age During Camp* Shirt Size* Email* Church Attending* Have you ever served at CYC before?* Yes No Year* What capacity?*Have you ever been convicted of a misdemeanor or a felony?*If selected, you will be required to complete a background check. Yes No Emergency Contact Name* First Last Emergency Contact Cell Phone*Emergency Contact Home Phone* Please check the week(s) of camp you would like to work/volunteer:*Please feel free to choose 1 or multiple weeks. Elementary Week will be set up a little different in 2023. K-2nd grades will arrive on Thursday, June 15 and will depart on Sunday, June 18 and 3rd-5th grades will arrive on Sunday, June 18 and depart on Friday, June 23. Due to the quick turn around on Sunday, June 18 - we are asking (only if you can) that if you volunteer for Elementary Week that you stay from Thursday, June 15 to Friday June 23. If you can not, that is not a problem. Just let us know what your schedule allows you to volunteer. Elementary Week (Grades K-2) // June 15-18, 2023 Elementary Week (Grades 3-5) // June 18-23, 2023 Middle School Week (Grades 6-8) // June 25-30, 2023 High School Week (Grades 9-12) // July 2-7, 2023 Why are you interested in working/serving at CYC?*Please mark the staff positions in which you are interested: Director Director's Assistant Program/Activities Lead Cook Cook Assistant Wrangler Lifeguard Nurse/Medical Please mark the volunteer positions in which you are interested:* Lead Counselor Assistant Counselor Program/Activities Assistant Kitchen Staff Photography Social Media Promo Choose any areas in which you are currently certified: Food Handlers License First Aid Lifeguard Registered Nurse CPR List any other special skills or certifications that would contribute to the ministry of CYC.(sports/music/drama/hobbies/outdoor skills/horses/etc) Pastor or Church LeaderName* First Last Church Name* Email* Phone*EmployerAre you currently employed?*YesNoName First Last Email PhonePersonal ReferenceName* First Last Email* Phone* My Personal WalkYour Story: Tell us how you came to know Christ and list any ministries that you are currently involved in.* Will you be attending CYC '23 as a camper?*If you are still in Middle or High School, and plan to attend CYC '23 as a camper please let us know by choosing yes or no below. Yes No What week are you planning to attend as a camper?*If you are in Middle or High School and are planning to attending CYC '23, please let us know what week you will be attending. THIS DOES NOT REGISTER YOU AS A CAMPER!!! YOU WILL STILL HAVE TO FILL OUT A CAMPER REGISTRATION. This is used to help us to apply a discount to your camper registration if you are selected to be a volunteer. Middle School WeekHigh School WeekVolunteer Discount Agreement*As a thank you, we would like to help pay for you to attend CYC if you are chosen as a volunteer. We have updated some of our policies and the team has agreed to continue to provide this gift. It is a little different than in years past, so we want to make sure that you are aware of this information before you complete your application. We will be offering a discount of $50.00 per volunteer week that can be applied to your registration. (Example: If you volunteer during middle school week and attend high school week, we will apply a $50 discount your camper registration.) Yes, I have read and I understand the volunteer discount. Do you have children that will be attending CYC in 2023?* Yes No Camper Information*If you have children that will be attending CYC '23, please list their name, birthday, gender and week that they will be attending. THIS DOES NOT REGISTER YOUR CAMPER!!! You will still have to register your camper - this is used to help us to apply a discount to your camper if you are selected to be a volunteer. (Example: John Doe - Oct 1, 2011 - Male - Middle School Week)Volunteer Discount Agreement*As a thank you, we would like to help pay for your camper to attend CYC if you are chosen as a volunteer. It is a little different than in years past, so we want to make sure that you are aware of this information before you complete your application. We will be offering a discount of $50.00 per volunteer week that can be applied to your child's registration. (Example: If you have 2 children and you volunteer during middle school week, we will apply $50 to 1 of your children's camper registration.) Yes, I have read and I understand the volunteer discount. I understand that this is an application for Staff/Volunteer service. I understand that I will be required to abide by all camp policies, standards, and regulations. I further understand that when my service is completed, I must return all of CYC’s property in my custody.I hereby authorize CYC to contact employers and any references listed herein to verify all information provided and to obtain any and all information related to my character and past work performance. I further hereby release all references from any liability for information provided in good faith.I hereby affirm that I have read the CYC Camp Statement of Faith. I hereby agree not to promote personal beliefs and doctrines that may differ from this statement, nor to exhibit conduct which is contrary to it.I hereby affirm that I have read the CYC Camp Staff/Volunteer Policy.I understand that CYC is a tobacco free, alcohol free, and drug free environment.I affirm that I have neither been convicted or, nor am I the subject of pending charges for any offense involving actual or attempted child abuse or sexual molestation in any jurisdiction. A criminal records release must be completed by all staff and volunteers participating in CYC sponsored programs. This information will be kept confidential, on file at the camp office.I hereby give CYC permission to conduct a criminal records search in the counties of residence listed above. I understand that this information is being gathered to ensure the safety and well-being of campers and staff at CYC.The applicant has permission to engage in all camp activities, both on-campus and off-campus. I have familiarized myself with camp program and events and understand that all activities are completely voluntary. I recognize the inherent risk of injury from participation in camp activities including (but not limited to): swimming, archery, BB guns, challenge course, horse program activities. I understand that CYC has taken safety measures, including having certified staff in first aid, CPR, water safety, challenge course, and horse programs, as well as making every effort to aid the safety of all camp participants. However, I also recognize that CYC cannot ensure or guarantee that the participants, equipment, grounds and/or activities will be free of accidents or injuries. I am aware and have instructed my child (if applicant is under the age of 18) about the importance of knowing and abiding by camp rules and regulations. I voluntarily waive any claim against CYC, its staff members, and Board of Directors, against all liability, claims, damages, attorney fees, or expenses arising out of or in connection with camp activities.I hereby give permission for images of myself/my child, captured during regular and special camping activities through video, photo, and digital camera, to be used solely for the purposes of CYC/PFWB promotional material and publications, and waive any rights of compensation or ownership thereto. I also understand that by providing my email address and cell phone number I will be included in text and email lists for CYC marketing purposes. We will never provide your contact information to any other organization for marketing purposes.I hereby affirm and acknowledge, by signing (electronic signature) below, that all of the information provided and all of my answers to the questions on this application are true and complete, and that any misrepresentation or omission may be grounds for rejection or, if later “employed,” dismissal.Applicant Signature*Parent Signature (if under age 18):