Volunteer With Us

Time to make a difference

Want to volunteer with us?

Please read the following material, then follow these Instructions

Volunteers serving during the summer camp sessions of Four Corners Encampment must be at least 16 years of age to volunteer at Session 1 and at least 18 years of age to volunteer at Session 2. Each session director reserves the right to recruit and assign volunteers for his session. The submission of this application does not guarantee an appointment as a volunteer at Four Corners Encampment. You will be contacted regarding the status of your application.

Instructions:

Print and complete the “Staff Health Evaluation” prior to starting the application
After completing the health evaluation document (step 1), complete the Online Volunteer Application.
Before the start of camp, follow the instructions in the “Child Care Background Check Overview” and “Background Check” document.
Submit an updated resume to four.corners.youth.encampment@gmail.com.
Visit the Colorado Professional Development Information System (PDIS), create an account and complete Standard Precautions Training. Please note: When creating an account, please enter “Montezuma County” in the “County of Residence” box.
Upon Completion of all of these steps, you will receive communication from FCYE.

Volunteer Application

"*" indicates required fields

Step 1 of 5 – Volunteer Info

Volunteer Information

At which session(s) do you want to work?*

Session One

Session Two

(Check all that apply)

How would you like to serve?*

Leader (Must be at least 18 years of age and and be one full year removed from high school)

Cabin Leader (Must be at least 16 years of age)

Kitchen Helper

Nurse

Other

Medical Qualifications*

Please list your medical qualifications. The camp nurse must be a licensed physician, a registered nurse, a licensed practical nurse or holds a current American Red Cross Advanced First Aid certification as an Emergency Medical Technician or equivalent, must also have Medical Administration training

Name*

First Last

Address*

Street Address Address Line 2 City State ZIP Code

Home Phone*

Email*

Sex*

Male

Female

Age*

Please enter a number greater than or equal to 16.

Age at start of camp

Birthdate*

Grade

Unisex Shirt Size*

Parent or Legal Guardian*

First Last

If the prospective staff member is younger than 18 years of age, the name of a parent or legal guardian must be provided

Additional Volunteer Information

Have you been baptized?

Yes

Where were you baptized?

Church Home

Location

Elder or Minister Name

How often do you attent?

Emergency Contact

Name*

First Last

Home Phone*

Work Phone*

Personal References

All prospective staff members must provide the names of three personal references. These may be from leaders in your congregation, teachers and/or administrators at your school, employers and/or supervisors, or persons in the community and/or business. They may not be relatives or spouses. These references will be checked prior to your appointment as a staff person at Four Corners Encampment.

Reference #1

Name*

First Last

Phone*

Relationship to Applicant*

Reference #2

Name*

First Last

Phone*

Relationship to Applicant*

Reference #3

Name*

First Last

Phone*

Relationship to Applicant*

Volunteer Consent

Name of the Volunteer*

First Last

Consent to Uphold and Abide By all Camp Policies*

By checking this box, I confirm that I understand the Camp Policies and will uphold and abide by these policies at all times while acting as a volunteer staff member

CAMP POLICIES

Every person is required to follow the camp schedule unless excused by the session director.

The “raiding” of cabins and/or hazing of any kind is absolutely prohibited.

The harm of other persons and/or the destruction of property are grounds for immediate dismissal from camp.

Each camper must bathe regularly and be properly groomed and attired. Modest dress and undergarments are required for males and females. The staff, and session director retain the authority to ask anyone on the premises to change their attire if it is deemed inappropriate for camp. When packing clothing, remember to bring clothing appropriate for warm and cold temperatures.

Alcohol, illicit drugs, tobacco and any harmful substances are not permitted.

Guns, hunting knives, hatchets, matches, or fireworks are not permitted. Possession of these items is grounds for immediate dismissal from camp.

Abusive and/or profane language are not permitted. The respectful and honest treatment of all persons is expected.

All prescription and non-prescription medication, vitamins, and/or supplements of any kind MUST be given to the camp nurse upon registration. The nurse must be notified of any medication routine. All persons must bring their own sunscreen. The camp will not provide any and no sharing of sun screen will be allowed.

No camper is allowed to leave the premises without the permission of the camp director and without the accompaniment of those specifically noted in this form. Parents are asked to check in with the camp director before taking their child off the premises.

Cell phones are permitted for camera use only. Any personal media use is permitted only at the discretion of the session director.

Do not bring food or beverages to camp. All food, snacks , and beverages will be supplied by the camp. There is NO food allowed in the cabins.

Visitors must check in with the camp director and abide by all policies outlined in this section. All vehicles should be parked in the designated area.

The session director may expel any person (camper, staff member, or visitor) from camp premises if there is conduct is detrimental to the camp.

Consent to Administer Medical Care*

By checking this box, I consent to administer medical care

I authorize Four Corners Encampment to administer and /or seek appropriate medical care on my behalf. I know that in the case of emergency (specifically, in the event I become incapacitated), effort will be made to contact my emergency contacts (using the emergency numbers listed in the application). If, however, no one can be reached, I hereby give permission to the physician, nurse practitioner, paramedic, first responder, or other trained healthcare professional selected by the camp director and/or its medical staff to hospitalize and secure proper transport and treatment (including surgery and invasive medical procedures) for myself. I also give permission for the camp medical staff to administer non-prescription health aid.

Health Insurance Company*

Health Insurance Policy Number*

Consent To Administer COVID19 Testing*

By checking this box, I consent to Administer COVID19 Testing

I authorize Four Corner Youth Encampment to Administer approved COVID19 tests to determine if a staff personal will test positive or negative of having COVID19. These persons would include those who are showing symptoms and/or is in close proximity to someone who is showing symptoms or tests positive. Tests will be administered by licensed medical personal.

Background Check*

By checking this box, I confirm the following statement is true

I affirm that I have not been convicted of child abuse, unlawful sexual offense, or any felony. I grant Four corners Encampment, Inc. permission to obtain a copy of my criminal record. If serving as a staff member at Four Corners Encampment for an annual cumulative period of 14 days or more, I know that I must submit to a C.D.I. or F.B.I. Abuse and Neglect Background Check, including the submission of fingerprints.

Letter of Agreement*

By checking this box, I confirm the following statement is true

I have read through the Four Corners Encampment Staff Manual (available by request) and accept all of the responsibilities and obligations listed therein for the position to which I am applying. I am aware of the camp protocols, rules, and procedures. I will do my best to uphold the standards and goals of Four Corners Encampment. I will cooperate with the camp director(s) and other staff members in demonstrating the Christian walk by my speech, dress and conduct.

Child Abuse Reporting Statement:*

By checking this box, I confirm that I have read and understand the below requirements concerning my responsibility regarding child abuse reporting.

Child Abuse Reporting Statement:

Under the Child Protection Act of 1987 (C.R.S. 19-3-301) in the Colorado Children’s Code, child care center workers are required to report suspected child abuse or neglect. The law at 19-3-304 states that if a child care worker has “reasonable cause to know or suspect that a child has been subjected to abuse or neglect or who has observed the child being subjected to circumstances or conditions which would reasonably result in abuse or neglect shall immediately report or cause a report to be made of such fact to the county department or local law enforcement agency.”

“Abuse” or “child abuse or neglect” means an act or omission in one of the following categories which threatens the health or welfare of a child: skin bruising, bleeding, tissue swelling, or death; any case in which a child is subjected to sexual assault or molestation, sexual exploitation, or prostitution; any case in which a child is in need of services because the child’s parents, legal guardian, or custodian fails to take the same actions to provide adequate food, clothing, shelter, medical care, or supervision that a prudent parent would take.

If at any time a staff member reasonably suspects child abuse, it is the responsibility of that staff member to report or to cause a report to be made of this suspicion to the local county department of social or human services at Cortez, Montezuma County, Colorado (970-565-3796) or the police department. It is not staff’s role to investigate suspected abuse – only to report it. Persons who make a good faith report are immune from civil and criminal liability. Additionally, the law provides for the protection of the identity of the reporting party.

A child care worker who fails to report suspected child abuse or neglect commits a class 3 misdemeanor and will be punished as provided in section 18-1-106, C.R.S. The staff person could also be liable for damages “proximately caused thereby.”

Confirmation*

By checking this box, I confirm that all the information I have provided in this application is true to the best of my knowledge and that I understand the following statement.

Any applicant who knowingly or willfully makes a false statement of any material fact or thing in the application is guilty of perjury in the second degree as defined in Section 18-8-503, C.R.S., and upon conviction thereof, shall be punished accordingly.

Photo Release

By checking this box, I hereby consent to Four Corners Youth Encampment using any photos/videos of me during this camp session for use on their website or any other camp approved advertising.

Staff Health Evaluation

Accepted file types: pdf, png, jpg, jpeg, Max. file size: 300 MB.

Please Upload staff health evaluation. Acceptable file formats: pdf, png, jpg, jpeg

Parental / Guardian Consent

If you are under 18 years of age, your parent or guardian must complete the following in affirmation of this application.

Name of the Parent or Guardian*

First Last

Confirmation*

By checking this box, I, as the parent or guardian of the applicant, confirm that all the information provided in this application is true and that the applicant has completed this application with my permission.

Phone

This field is for validation purposes and should be left unchanged.

Volunteer With Us

Time to make a difference

Want to volunteer with us?

Please read the following material, then follow these Instructions

Volunteer Application

Volunteer Information

Additional Volunteer Information

Emergency Contact

Personal References

Reference #1

Reference #2

Reference #3

Volunteer Consent

Parental / Guardian Consent

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