FUN — Elementary — HS Leader Interest Form

June 12-16, 2023 • 9AM-1PM

July 17-21, 2023 • 9AM-1PM

Please use this form to let Kids Ministry know you are interested in serving with Elementary Fun Camp.
You will be contacted regarding your interest to serve.

All HS Leaders must be entering the 9th through 12th grade, be walking in relationship with Jesus (no one's perfect, but we're looking for intentionality and willingness to grow), and have a heart for helping children/middle school students belong and have a blast as they get to know Jesus. HS Leaders must also attend the required Leader Training the week before.

Please read and sign the HS Leader Agreement on this interest form. Both the parent and the youth must e-sign the form for the youth to be considered for service. Please keep the email you receive as your copy of this agreement. You will be contacted regarding your inquiry to serve. Thank you!

OPTIONS:
Elementary FUN Camp - Week 1 • June 12-16
Elementary FUN Camp - Week 2 • July 17-21

STEP 1: Please complete one interest form per student.

YOUTH INFO

student name

First Name *

Last Name *

student info

Gender *

Birthday *

Age *

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Upcoming Grade (23-24) *

Upcoming School (23-24) *

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Student Cell

Student Email

Email

Confirm Email

TShirt Size *

ADDRESS

Who do you live with? *

Address *

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City *

States *

Zip *

PARENT/GUARDIAN INFO

Emergency Contact

Parent 1

Parent/Guardian Name *

Cell *

Relationship *

Parent Email *

Email

Confirm Email

YOUTH MEDICAL INFO

Leave blank if not applicable

Allergies/Medical Needs (medical/dietary/physical needs)

SERVE INFO

Have you volunteered at University Carillon Camps in prior years? *

Yes
No

Which Elementary Fun Camp week(s) will you be working? *

TIME AWAY

Are you able to be at camp for the entire week (Monday - Friday) *

Yes:
No

If not, what days/times will you be gone? Reason? *

BRIGHT FUTURES

Will you be needing Bright Futures hours? *

Yes:
No

*PHOTO/VIDEO RELEASE

For privacy and safety, we will not publish names with photographs/videos.
I authorize the use/release of photographs and/or videos that include the INDIVIDUALS NAMED ABOVE for University Carillon and EPIC use, in print and electronic materials (worship videos, e-mail blasts, church website, Facebook, etc.).

Photo/Video Release: *

Given
Denied

HS LEADER AGREEMENT

Thank you for your interest in servant-leadership for Summer Camps! Our HS leaders are a tremendous resource and we value their help each year. Below are some guidelines to follow when serving with our camps. Please read these guidelines over and sign the bottom. Your e-signature indicates that you understand your responsibilities. You will be contacted regarding your inquiry in serve.

By signing this agreement, I'm pledging my support in the following ways:

I agree to model servant-leadership by putting the camp participants first; reminding them they are seen, known and loved, the way Jesus sees, knows and loves them.
I agree to perform the duties at the direction of staff/leadership, with a servant-heart. Sometimes it means doing the jobs that no one else wants to do, and doing them with joy, intentionality and selflessness, just as Jesus knelt to wash dirty feet.
I agree to lead with integrity. This means how I portray myself at EPIC/University Carillon and away from EPIC/University Carillon matters. (Drug/alcohol use, inappropriate sexual behavior, bullying of any kind, gossip, stirring up unhealthy drama, and cursing are incompatible with the message of Jesus.)
I agree to encourage the responsible behavior of my peers, who have also agreed to serve.

HS Leader Agreement *

I understand my responsibilities

*RELEASE

Submitting this on-line form will be the equivalent of signing a paper registration form.

I have read and understand the above information. The information I have given EPIC is accurate and true to the best of my knowledge.
My electronic signature signifies my understanding that submitting this online form will be the equivalent of signing a paper registration form.

Release *

Yes, I agree

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Student Electronic Signature *

Parent/Guardian Electronic Signature *

Date *

After submitting your form, WATCH FOR Confirmation Email.

One from our web specialist with the responses from your registration.