Summer Camps Employment Form

SUMMER CAMPS EMPLOYMENT FORM

Camp Name:   Season Year:

Position Applied For

Position(s) desired: Counselor Lifeguard Nurse/Health Staff Kitchen Staff Maintenance Administrative Other:

Personal Information

Date of Birth:   Phone:   Email:

Emergency Contact

Relationship:   Phone:

Position Information

Reporting Manager (if known):   Available Start Date:   Available End Date:

Availability

Days available: Mon Tue Wed Thu Fri Weekends

Certifications & Qualifications

CPR Certified First Aid Certified Lifeguard Certification Food Handler Certification Valid Driver's License

Employment History (Most Recent First)

Job Title:   Dates Employed From:   To:

Job Title:   Dates Employed From:   To:

Education

Graduation Date:   Major / Area of Study:

References (Professional)

Phone:   Email:   Relationship:

Phone:   Email:   Relationship:

Phone:   Email:   Relationship:

Background & Safety Disclosures

Have you ever been convicted of a felony, or a misdemeanor involving physical contact or sexual misconduct? No Yes

Have you ever had a professional license or certification revoked or suspended? No Yes

Legal Notices & Disclosures

At-Will Employment: If employed, your employment with the camp is on an at-will basis, which means either you or the camp may terminate the employment relationship at any time, with or without cause or notice, unless a separate written agreement signed by an authorized representative of the camp provides otherwise.

Equal Opportunity: The camp provides equal employment opportunity to all applicants and employees and does not discriminate on the basis of race, color, religion, sex, national origin, age, disability, or any other protected characteristic under applicable law.

Child Safety & Background Checks: All offers of employment are contingent upon satisfactory completion of criminal background checks, reference checks, and, where applicable, child abuse registry checks. Applicants must disclose any convictions or pending charges relevant to the safety of children. Failure to disclose such information may result in withdrawal of an offer or termination.

Authorizations & Applicant Certification

By checking the box below and signing this form, I certify under penalty of perjury that the information I have provided on this form is true, complete, and correct to the best of my knowledge. I understand that false or misleading information may result in withdrawal of any offer of employment or immediate termination if employed.

I authorize the camp, its agents, and contractors to contact prior employers, educational institutions, and references provided herein for the purpose of verifying my statements and evaluating my suitability for employment. I further authorize the camp to obtain criminal history, motor vehicle, child abuse registry, and other background checks as permitted by law. I release from liability individuals and organizations who provide truthful information in response to inquiries made in connection with my application.

I consent to background/reference checks and authorize the disclosures above.

I authorize emergency medical treatment if needed during my employment or on camp premises.

I understand that completion of this form does not guarantee employment and that any employment offer may be conditioned upon additional screening, drug testing, and verification of eligibility to work.

Applicant Certification Statement

I certify that I have read and understand the above statements and that I am the individual identified on this form. I give permission for the camp to confirm any of the information provided and to collect consensual background information as permitted by law.

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