Volunteer for Impact Fall Retreat

November 12, 2021 - November 14, 2021

235 out of 250 remaining tickets available

<p>Thank you for volunteering for Fall Retreat 2021!  Our staff are highly valued as their efforts are crucial to a successful retreat experience.  Positions will be accepted and assigned on a first come first serve basis.  Please note that NO REFUNDS will be given if an application is not accepted or the desired position is re-assigned.  If there are any questions, please contact impactetx@gmail.com before applying.  This form will close on October 31 to allow time for proper screening.  Now get ready to make an IMPACT.  </p>

Type

Price

Quantity

Fall Retreat Volunteer Registration Fee

235 Remaining

Price
$20.00

Quantity

Fall Retreat Volunteer Registration Fee 0

Impact East Texas Fall Retreat 2021

General Information

Thank you for your interest in volunteering!

WHO NEEDS TO APPLY
This application is to be completed by applicants for any position involving the supervision or custody of minors. It is our goal is provide a safe and secure environment for the everyone that participates in our camp program and uses our facilities. Submission of an application does not guarantee your selection. Selection is based upon the needs of the camp and a positive recommendation by your pastor. All worker forms are due by October 31.

APPLICATION FEE
There is a $20 application fee due at registration to cover administration costs. Tithe.ly will add an additional 3% fee.

AGE REQUIREMENTS
Monitors and leadership positions must be filled by applicants at least 21 years old.

EXPECTATIONS
This is an important role for our camp. You must be actively monitoring campers at all times. All schedules and assignments provided by the Camp Director must be adhered to at all times. You will also be expected to follow the dress code and rules and be an example to the youth.

***Camp Director and Bishop Reserve the right to refuse anyone from volunteering***

First Name *

Gender *

Last Name *

Marital Status *

Date of Birth *

I agree that Impact East Texas can perform a background check on me *

Yes

Social Security Number (required for background check) *

Mailing Address *

Mailing City *

Mailing State *

Email Address *

Mobile Number *

Church Name *

Pastor's Name *

In which worker position(s) would you be willing to serve? *

Emergency Contact Information

Emergency Contact Name *

Emergency Contact's Relationship to Worker *

Emergency Contact Phone Number *

Worker Medical Questionnaire

Insurance Company Name

Insurance Company Address

Insurance Policy Number

Name of Policy Holder

This volunteer is in good physical condition and may participate in ALL physical activities *

Please list any and all activities that this volunteer may not participate in *

This volunteer may receive first aid or medication if deemed necessary *

Date of Last Tetanus Shot

Does this volunteer have any allergies to medication? *

Please list all medications that this volunteer is allergic to *

Does this volunteer have any allergies? *

Please list any allergies that this volunteer has *

Volunteer Questionnaire

Have you ever been accused of, engaged in, or investigated for any sexual or physical offense involving a minor or adult, including but not limited to child abuse, child molestation, indecent liberties with a child, incest, sexual harassment, seduction, rape, assault, battery, murder, kidnapping, child pornography, sodomy, or sexual contact with a counselee or church member? *

Have you ever been convicted of, or pled guilty or "no contest" to, any criminal offense described in the above question? *

Have you ever been convicted of, pled guilty or "no contest" to any criminal offense not mentioned in the above question *

Please explain your past criminal charges *

Do you use any alcoholic beverages? *

Do you use any tobacco products, including e-cigs or vapes? *

Do you use any illegal nonprescription drugs or prescription drugs illegally? *

Do you have any Christian camp experience? *

Are you able to stay for the entire event? *

I understand that my job assignment may be reassigned by the camp director or other authorized camp personnel *

Are you a born again Christian according to John chapter 3? *

List any gifts, callings, trainings or other factors that have prepared you to work with students. *

Are you baptized in the Holy Spirit with the external evidence of speaking in tongues according to Acts 2:4? *

I agree to abide by all of the rules and regulations of the camp. I understand that my refusal to obey the rules of Fall Retreat could lead to me being sent home without refund. *

I agree to abide by the rules

I do not agree and will just stay home

I understand that I am financially responsible for any/all medical claims procured. I waive any/all claims against the District/National PCG, the District Board, its representatives, and campground staff/workers because of any injury or other damage that may be incurred to me or my property in connection with, or incident to, the Pentecostal Church of God.

The information contained in this application is correct to the best of my knowledge. I authorize any references or churches listed in this application to give you any information (including opinions) that they may have regarding my character and fitness for children and youth work. In consideration of the receipt and evaluation of this application by the East Texas District Pentecostal Church of God Inc., I hereby release any individual, church, youth organization, charity, employer, reference, or any other person or organization, including record custodians, both collectively and individually, from any and all liability for damages of whatever kind or nature which may at any time result to me, my heirs, or family, on account of compliance or any attempts to comply, with this authorization. I waive any right that I might have to inspect any information provided about me by any organization identified by me in this application. Should my application be accepted, I agree to be bound by the Bylaws and policies of the East Texas District Pentecostal Church of God, Inc., and to refrain from unscriptural conduct in the performance of my services on behalf of the church. I understand that the position for which I am applying has a required time for arrival and dismissal on the campgrounds. I understand that I must be at the campgrounds by that required time the first day of Youth Camp.

I further state that I HAVE CAREFULLY READ THE FOREGOING RELEASE AND KNOW THE CONTENTS THEREOF AND I SIGN THIS RELEASE AS MY OWN FREE ACT. This is a legally binding agreement which I have read and understand.

Volunteer Electronic Signature *

Tip: This is your electronic signature. By typing your name you are agreeing to the information you provided on this form.