Staff Application – Camp Jubilee 2024 Staff Application – Camp Jubilee 2024 Updated camp staff application for 2024 Name* First Last For which week of camp would you like to work?*Mountain Top Youth Camp (June 29 – July 4) – Pinnacle, NCBetsy Jeff Penn 4H Center (August 4 – 8) – Reidvsille, NCI am willing to work both weeks of camp this year!T-Shirt Size*Adult SmallAdult MediumAdult LargeAdult Extra-LargeAdult 2XLAdult 3XLYouth SmallYouth MediumYouth LargeGender*FemaleMaleAge*Birthdate* MM slash DD slash YYYY Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email* Primary Phone* Secondary Phone* Camp Experience*List and describe any church/mission work experience. List any training or experience that has prepared you for working with campers with special needs.Areas of ServiceIt is expected that teenage and young adult volunteers serve as counselors.Please select your preference of service.*SelectSenior Counselor (18 and older with experience with special needs, may be required to assist with personal hygiene)Senior Counselor (18 and older without experience with special needs)Junior Counselor (16-18 years old with experience with special needs)Junior Counselor (16-18 years old without experience with special needs)Insurance InformationProvider* Policy Number* Primary Subscriber* Group Number* Effective Date* MM slash DD slash YYYY Medical InformationEmergency Contact* Primary Phone* Secondary Phone* Relationship* Are you in good health?* Yes No If no, please explain. Do you have any physical limitations that would determine your activity as a staff person?* Yes No If yes, please explain: Do you have any allergies?* Yes No If yes, please explain: Do you use an Epi Pen? Yes No Do you take any regular medications?* Yes No If yes, list all medications: Any known communicable diseases? (HIV/AIDS, Hepatitis Type, Other) If this information is not included, in case of emergency safety protocol will be followed)* Background InformationHave you ever been convicted of any criminal offense other than a minor traffic violation?* Yes No If yes, please explain: Have you ever been charged with child abuse or a crime involving actual or admitted sexual molestation?* Yes No If yes, please explain: Background AcknowledgementBackground Check Permissions I give permission for MJM to complete a background check. I am under 18 and exempt from the background check. Authorized Signature (if applicant is over 18) Typing your name will be treated as your signature and is binding!Social Security NumberA Social Security number is required for the background check. Your information is protected and never shared or used for anything other than a background check. PermissionsPermissions:* Select All I give permission to be checked for lice. I give permission to receive any medical treatment necessary for their health and well-being. I give permission to be transported by MJM staff and/or volunteers for medical emergencies. I give permission to be included in photos that may be used for marketing. NOTE: Typing your name will be treated as your signature and is binding! Authorized Signature (if applicant is under 18 a parent/guardian must sign) Applicant Signature (if applicant is over 18) Date* MM slash DD slash YYYY Dress Code & RestrictionsEach MJM volunteers will adhere to a modest dress code which will be monitored by the Sr. staff. We appreciate you honoring God and our campers in how you dress. • It is expected that modest attire should be worn throughout the camp (a modest one-piece swimsuit, loose fitting t-shirts that cover midriffs, no spaghetti straps, no tight-fitting or low-hanging pants or shorts, no short shorts or miniskirts.) • No tobacco, alcohol, illegal drugs, vape, smokeless devices, weapons of any kind. • Cell phone use should be limited to emergency contacts only.Signature* I am willing to follow the rules of Camp Jubilee as they may affect my dress, conduct, personal habits, etc. and to submit to the leadership of Camp Jubilee staff and the Director. NOTE: Typing your name will be treated as your signature and is binding!Personal InformationChurch Affiliation* Elder/Pastor* Elder/Pastor's Phone* Elder/Pastor's Email* Please list two personal references and include complete contact information. (not a relative – i.e.: friend, co-worker, teacher) PLEASE NOTE! NO counselor applications will be considered without this complete informationName* First Last Phone*Relationship* Email* Name* First Last Phone*Relationship* Email* Testimony (for new applicants only)Describe your personal relationship with Jesus Christ. Also, please write WHY you want to serve on staff at Camp Jubilee.TestimonyDoctrinal Statement of Faith of Mount Jubilee MinistriesThe following Biblical truths shape the foundation for the teaching and operation of Mount Jubilee Ministries. All who take an active role in the ministry are expected to agree with and uphold them. 1. The Bible is the inspired Word of God, inerrant in its original manuscripts and the final authority in all matters of faith and practice. (II Timothy 3:16 & 17) 2. There is one God, eternally co-existing in three distinct persons: Father, Son and Holy Spirit. (I Peter 1:2) 3. The Lord Jesus Christ is fully God and became fully man. Through His virgin birth, by His death and resurrection, the Lord Jesus Christ made salvation a free gift to all who receive Him. (John 3:16 & 36; Ephesians 2:8 & 9) 4. Each member of the human race is created in the image of God, but falls short of God’s glorious standard, sinful and lost. Regeneration by the Holy Spirit is absolutely essential for the salvation of each individual. Redemption is wholly by the blood of Christ, and salvation is by grace, through faith in our Lord Jesus Christ. (Romans 3:10 – 30) 5. God created and maintains all things by His sovereign power. (Colossians 1: 15 – 17) 6. The Church of our Lord Jesus Christ is composed of all true believers in the Lord Jesus Christ. True believers have assurance of eternal life and the power of the Holy Spirit to live righteous lives. (John 10: 27 – 29; Galatians 5:16 – 18) 7. The blessed hope of the Church is the personal and imminent return of the Lord: the saved to enjoy eternal bliss and the unsaved to experience eternal and conscious punishment. (Revelation 20: 11 – 15)Do you agree with the MJM statement of faith?* Yes No If no, please explain: HiddenPersonal & Church ReferencesPlease list two personal references and include complete contact information. (not a relative – i.e.: friend, co-worker, teacher) Please also list one leader from your local church as a reference and include complete contact information. PLEASE NOTE! NO counselor applications will be considered without this complete information.HiddenWaiver and release of LiabilityIn consideration of being allowed to volunteer my services for Mount Jubilee Ministries, Inc. (MJM) and Camp Jubilee, I hereby acknowledge that there are certain risks of injury involved, and I knowingly and freely assume all such risks and assume full responsibility for my participation. To the extent allowed by law, I agree to indemnify and hold harmless Mount Jubilee Ministries, Inc., its officers, employees, agents, representatives and volunteers, of all liabilities and all loss or damage to person or property which may occur or be incident to my involvement or participation.Volunteer Confidentiality AgreementI recognize that as a volunteer of Mount Jubilee Ministries, Inc. (MJM), a North Carolina non-profit corporation, I may have access to confidential information concerning MJM, its guests, agents, employees, volunteers or representatives. In consideration of any volunteer status with MJM, I agree I will not at any time, during or after volunteering for MJM, divulge or reveal to any person, firm or corporation, any information (including, but not limited to, personal or financial information or camper and family lists), directly or indirectly, which might in any way be used to injure or interfere with the business or ministry of MJM, or to alienate guests, agents, employees, volunteers or representatives from MJM or to cause discontent or dissatisfaction among any such persons. I agree that should I have any questions as to the propriety of release of any information, I will request clearance from MJM prior to releasing such information. By signing my name below, I am showing that I agree with the statements contained on this page.Signature* Date* MM slash DD slash YYYY By signing my name above, I am showing that I agree with the statements contained on this page. NOTE: Typing your name will be treated as your signature and is binding!Love OfferingVolunteer counselors are the lifeblood of Camp Jubilee and we could not exist wiithout them! While there is no fee to participate in camp, we welcome any and all love offerings to help cover the cost of housing and feeding our counselors. It costs $360 per counselor to cover room, board, and food. Would you be willing to consider a donation to help cover the counselor costs this year? Every dollar helps! If you indicate the ability to donate, below, we will email you a direct link. I can donate $360 to cover my room, board, and food. I can make a donation of another amount to help offset the cost of my room, board, and food. I am willing to find a sponsor church, organization, or friends & family to cover the cost of my room, board, and food. Contact Information For further information or questions contact: Candice Hughes, Camp Director (336) 951-9929 *protected email* or Angelica Villalta, MJM Program Director 336-813-4039 *protected email*