Returning Volunteer Application Form

Name

First Name

Last Name

Address 1

Address 2

City

State/Province

Zip/Postal Code

Phone

(###)

###

####

Email Address

Your T-shirt size

HEALTH/MEDICAL INFORMATION

Emergency Contact

Emergency Contact Phone

(###)

###

####

Personal Health Identification Number (9 digits)

Enter numbers only - no spaces

MB Health Registration Number

Birth Date

YYYY

Medical History/Medications

Please list any medical conditions, past surgeries or regular, prescribed medications you are taking.

Allergies/Dietary restrictions

Do you have any dietary restrictions or allergies? Please describe below (include environmental or drug allergies as well if applicable).

Availability

When are you planning to volunteer? Please check all that apply.

Teen Camp (grade 7-12)

Junior Camp (grade 3-6)

Squirt Camp (age 4-grade 2)

Family Camp

Fall Retreat

Snowdays Retreat

Other (or YLT)

Which church do you regularly attend?

Certifications

Do you have any of these certifications? If none, skip this section.

Food Handlers Certificate

Standard First Aid/CPR

Expiry dates

Please indicate the expiry dates of the certifications you checked above.

Lifeguard

If you are applying to be a lifeguard, please check YES

Yes

Lifeguard Certification

If yes, please indicate your valid certifications and their expiry dates

Accessibility

Describe any concerns/hesitations you may have about working at camp. Include any health/medical needs you may have that could help us better accommodate you during your time at camp.

REFERENCE - Please contact your reference prior to filling out this application so they are aware we will be contacting them. We will be sending them an email with a reference form to fill out on your behalf.

Personal or Pastoral/Spiritual Reference

Someone who has known you for a minimum of 2 years.

First Name

Last Name

Phone

(###)

###

####

A Criminal Record Check and/or Vulnerable Sector Check (Child Abuse Registry - MB residents) is required to volunteer at CHBC.

If you have one or both of these checks that has been issued within the last 3 years (2022-present), please send a scanned copy or clear photo to covenantheightsbiblecamp@gmail.com

If you sent proof of your checks in the last two years, please check that option below.

If you don't have either check completed we will be in touch with information on how to do this.

Criminal Record/Vulnerable Sector/Child Abuse Registry

CRC - Criminal Record Check VS - Vulnerable Sector CAR - Child Abuse Registry (MB only)

Accommodations

Please choose one of the options and answer the corresponding questions regarding your choice.

Camper/Trailer

If you chose to bring a camper/trailer, what is the size of the camper/trailer?

Commute

If you chose to commute, what town will you be staying in?

WAIVER AND RELEASE OF LIABILITY

By signing below, I give CHBC permission to seek whatever medical attention is deemed necessary, and release Covenant Heights Bible Camp (CHBC), its staff, and volunteers of any liability against personal losses of the participant named above. I, the undersigned, understand that there are inherent risks involved in any camp activity or athletic event, and I release CHBC, its staff and volunteers from any and all liability for any injury, loss, or damage to person or property that may occur during this event. In the case that the participant requires medical attention. I consent to any reasonable medical treatment as deemed necessary by a licensed physician. In the event that treatment is required from a physician and/or hospital personnel designated by CHBC, I agree to hold such person free and harmless of any claims, demands, or suits for damages arising from the giving of such consent. I affirm that the information provided on this form is accurate to the best of my knowledge.

I have read the waiver and release of liability

I agree and have signed below

Participant Signature

Please type your name here to be accepted as signature

Covenant Heights Bible Camp Purpose

To provide a Christian camping experience for the purpose of leading children, youth and adults in spiritual matters, seeking to impress upon them the need of accepting Jesus Christ as their personal Saviour, followed by instruction in living a Christian Life. Statement of Faith The Corporation believes in the Holy Scriptures, the Old and New Testament, as the inspired Word of God and as the only perfect rule for faith, doctrine and conduct. I understand the CHBC purpose and Statement of Faith. I agree to work with staff to this end while volunteering at camp.

Yes, I agree

No, I do not agree

By clicking SUBMIT on this application I agree that I have read, understand and will commit to working towards the CHBC purpose while volunteering at camp.