Day Camp 2025-Volunteer Application (Ages 18 and up)

Volunteer First and Last Name

Age

Date of Birth

Address

Phone

This address will receive a confirmation email

Volunteer T-Shirt Size

Adult Small Adult Medium Adult Large Adult X-Large Adult 2XL Adult 3XL Adult 4XL Adult 5XL

Emergency Contact information

1st Emergency Contact Name

Relationship to Volunteer:

Emergency Contact Phone Number

2nd Emergency Contact Name

Relationship to Volunteer:

Emergency Contact Phone Number

Food Allergies/Sensitivities:

Medical Conditions:

Cal Skate of Rohnert Park-Thursday, July 17th, 2025

On the last day of camp,Thursday, July 17th, we will be taking campers to Cal Skate of Rohnert Park. Campers/volunteers will need to bring a sack lunch from home for this day.

Skating Rink admission will already be paid for campers/volunteers, however if you would like to buy from concession or play any extra games available, you will need to bring cash to cover cost. Campers/volunteers are allowed to bring their own skates.

Parents/guardians who decide to join will need to cover their own admission/skate/concession fees.

Day camp hours this day will be the same as normal. Buses will leave Legacy Church campus at 11am and back around 4pm.

Please mark below if you would like to ride the bus for the field trip, driving yourself to the location, and/or willing to drive other volunteers to location if needed.

Location Info:
Cal Skate of Rohnert Park
6100 Commerce Blvd
Rohnert Park, CA 94928

Cal Skate Trip-July 17th 11am-4:00pm

Yes, I will be riding the bus. No, I will transport myself. Yes, I'm wiling to drive other volunteers if needed.

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 child or church member?

Yes No

Have you ever been convicted of, or pled guilty or “no contest” to, any criminal offense described in question 1?

Yes No

Have you ever been convicted of, or pled guilty or “no contest” to, any criminal offense not mentioned in question 1? (excluding minor traffic offenses)

Yes No

Do you use any tobacco products?

Yes No

Do you use alcoholic beverages?

Yes No

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

Yes No

Do you have any physical, mental handicaps or conditions preventing your involvement in certain types of activities? If YES, explain down below.

Yes No

If answered YES to question above, please explain here:

Have you had any Christian Camping experiences?

Yes No

To the best of your ability, are you willing to follow all camp rules and submit to camp policies?

Yes No

I am able to work all four days of camp.

Yes No

If answered no, please state what days/times you can commit to here:

I understand that my job assignment may be reassigned as needed by camp director or authorized camp personnel.

Yes No

Medical/Liability Agreement

I understand that I am financially responsible for any/all medical claims procured. I waive any/all claims against Legacy Church or any Legacy Church affiliates, District/National PCG, the District Board, and it's representatives, pastors, staff, and/or leaders because of any injury or other damage that may be incurred to me or my property in connection with, or incident to, Legacy Church.

The information contained in this application is correct to the best of my knowledge. In consideration of the receipt and evaluation of this application by Legacy Church., 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 policies and regulations of Legacy Church, 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 of church campus. I understand that I must be at the church campus by the required time for all four days of camp and/or days I have designated that I will work.

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.

Medical/Liability Agreement

Yes, I understand and agree to Medical/Liability statement.

Media Release

I hereby irrevocably consent to and authorize the unrestricted use and reproduction by Legacy Church or anyone authorized by Legacy Church, of any and all photographs and/or video images which Legacy Church have taken of the camper listed above, for use within the scope of Legacy Church, Legacy Kids, Legacy Youth, and or Pentecostal Church of God.

Media Release

Yes, I understand and agree to the Media Release. No, I do not consent to the Media Release.

Volunteer's E-Signature

E-Signature Date

Day Camp 2025-Volunteer Application (Ages 18 and up)

Description

Please Fix the Following