Returning Counselor Application

Returning Counselor Application

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T-Shirt Size
Do you have certification in the following?
This year I would prefer my campers to be

PERSONAL GROWTH

CRIMINAL BACKGROUND

Have you ever been convicted of or pleaded guilty to any crimes including municipal, state, and federal?
Have you ever been placed on probation, received a Suspended Execution, Suspended Sentence or Suspended Imposition of Sentence for any offense involving a minor child (a child under 18), or been placed on ANY local, state, or federal sexual registry?
Have you ever been sued in a civil court of law where the allegations in the suit involved illegal, inappropriate, or sexual conduct or contact with a minor child?
Have you ever been subject to any court order involving any sexual, physical, or verbal abuse including but not limited to any domestic violence or civil harassment injunction or protective order? 
Have you ever resigned, been terminated, or been asked to resign from a position, whether paid or as a volunteer, due to a complaint(s) of sexual, physical or verbal abuse of minors?

REPRESENTATIONS AND RELEASE

I understand that for the church to carry on a RFK Camp, it has had to agree to abide by certain policies and parameters established by RFK, including strict policies against any form of child abuse, and that violation of these policies may be cause for dismissal. Child abuse is punishable by law, and the church is bound by law to report allegations of abuse or any inappropriate sexual contact to the proper authorities. ALL reporting is kept confidential, by law. All volunteers must commit to immediately report any behavior that seems suspicious, questionable, abusive or inappropriate between child-to-child, staff-to-child, and staff-to-staff. If YOU are struggling with sexual attraction to children, please opt out of service in the church’s RFK Camp or any other child-serving organization and seek help. One option is: “Hope for the Heart” at (800) 488-HOPE (4673) or www.hopefortheheart.org. I understand that I will be required to submit to a background check as a condition of acceptance as a volunteer, and that unsatisfactory results, refusal to cooperate, or any attempt to affect the results of these background checks will result in me being removed as a volunteer or volunteer applicant. I hereby certify that all of the information provided by me in this Application (or in any other accompanying or required documents) is correct, accurate and complete to the best of my knowledge. I understand that the falsification, misrepresentation or omission of any facts in these documents may (or will) be cause for the denial of acceptance as a volunteer, or immediate removal as a volunteer, regardless of the timing or circumstances of discovery. In consideration of the receipt and evaluation of this Application by the sponsoring Church, I hereby authorize you to contact any references, churches, youth groups, schools attended, former and present employers, charities, courts, and any other person, agency, or organization that may have information about me, and for them to provide to you such information (including opinions) that they may have regarding my character and fitness for working with children; I hereby release any such references, churches, youth groups, schools attended, former and present employers, charities, courts, and any other person, agency or organization who may have provided information about me, 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 also agree to hold RFK, the sponsoring church, RFK Camp Leadership, and any other person to whom the release above applies, harmless from any damages, specifically including attorney fees and court costs, created by or relating to my unwarranted attempt to collect damages for providing information described above or any other unwarranted action by me in connection with this Application. I waive any right that I may have to inspect any information provided about me or by any person or organization identified by me in the Application process. In addition, I hereby release, and agree that I, my successors, assignees, heirs, guardians and legal representatives will not make any claims or take any legal actions against, RFK or any of its affiliated organizations, or its officers, directors, employees, agents, or volunteers (“Released Parties”), for my injury, death, damage or loss, however caused, arising from or in connection with my participation in RFK activities, with the exception of my injury, death, damage or loss as the direct result of illegal or grossly negligent acts by RFK, and I will hold the Released Parties harmless from any costs or loss, including attorney fees and court costs, arising from or in connection with my activities in violation of these provisions. I understand that submission of an application does not guarantee my acceptance as a volunteer. I further understand that should the church extend an offer to me as a volunteer, it is for no specific duration and may be revoked by either the sponsoring church, or me at any time, with or without cause. I understand that none of the documents, policies, procedures, actions, statements of RFK, the sponsoring church, the RFK Leadership or their representatives and agents used during the volunteer application process is deemed an offer for a contract or in fact a contract, real or implied. If accepted as a volunteer, I agree to conform to the rules, regulations, policies, and procedures while serving as a volunteer, and understand that such compliance is a condition of remaining a volunteer. All Royal Family KIDS Camps are operated as a ministry of a local Sponsoring Church or in conjunction with a local non-profit organization. As such, all volunteers will fall under the authority of the Camp Leadership as trained by the RFK National Office and under the authority and beliefs of the Sponsoring Church. The Sponsoring Church may or may not require membership or attendance of their church, but all volunteers need to understand that church leadership has authority over the operations and expectations of the RFK Camp and the churches beliefs will inevitably be evident in the selection process and operation of the RFK Camp as a ministry of their church. I have carefully read the above Application and this Acknowledgement and Release and know and understand its contents; I also know the above is legally binding on me. I sign this Application and Release of my own free will.
Name printed
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Witness Name
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