Employee Career Camp Roster

EMPLOYEE CAREER CAMP ROSTER

Event Details

Location:    Cohort/Session:

Start Date:    End Date:

Personal Information

Phone:    Email:

Position Information

Reporting Manager:    Start Date (with employer):

Employment History (Most Recent 2 Employers)

Title:    Dates Employed:

Title:    Dates Employed:

Education

Graduation Date:

Professional References (3)

Phone:    Email:

Phone:    Email:

Phone:    Email:

Emergency Contact & Health

Relationship:    Phone:

Session Assignments & Attendance

Assigned Track:    Cohort Leader:

I will attend: Leadership Workshop

I will attend: Technical Skill Sessions

I will attend: Networking & Career Planning

Legal Notices, Policies, and Authorizations

At-Will Employment: Participation in this Career Camp is not a guarantee of continued employment or promotion. Nothing in this roster or in camp activities alters the at-will employment relationship; either the employee or employer may terminate employment at any time, with or without cause, unless governed by a separate written agreement signed by both parties.

Equal Opportunity Statement: The employer provides training opportunities without regard to race, color, religion, sex, national origin, age, disability, or any other protected characteristic. Reasonable accommodations for qualified individuals with disabilities will be evaluated on a case-by-case basis.

Assumption of Risk and Release: By signing below the participant acknowledges that attendance at certain camp activities may involve inherent risks. The participant agrees to follow all safety instructions and understands that the employer is not liable for injuries resulting from failure to follow instructions, intentional misconduct, or willful disregard of safety rules. To the extent permitted by law, the participant releases the employer from liability for ordinary negligence related to camp activities, except where such release is prohibited by applicable law.

Emergency Medical Treatment Authorization: In the event of a medical emergency, the participant authorizes camp personnel to obtain necessary medical treatment and to disclose relevant medical information to providers as required for treatment. The employer will attempt to notify the emergency contact as soon as reasonably possible.

Photograph/Recording Consent: The participant consents to being photographed, filmed, or recorded during camp activities. Photographs and recordings may be used by the employer for training, promotional, or internal communications purposes unless the participant submits a written objection signed and dated prior to the start of the camp.

Confidentiality & Proprietary Information: Participants must not disclose confidential or proprietary information obtained during camp sessions. All training materials remain the property of the employer and may not be reproduced or distributed outside of authorized channels.

Background Checks and Employment Verification: The participant authorizes the employer to verify employment history, education, and professional references, and to obtain consumer reports and background checks when required for participation. The participant acknowledges that falsification or omission of information may disqualify them from participation and may result in disciplinary action up to and including termination.

Applicant Certification & Authorization

I certify under penalty of perjury that the information provided on this roster is true, complete, and accurate to the best of my knowledge. I authorize the employer to contact the persons and organizations identified herein for purposes of verifying qualifications and suitability for participation. I understand that failure to comply with camp policies or submission of false information may result in removal from camp and potential disciplinary action.

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