During the summer there are moments when your parents may need to be contacted.  Please provide their phone numbers below.  Type N/A if a parent doesn't have a cell / home phone.

The information contained in this application is correct to the best of my knowledge. I authorize Camp Deer Run to obtain information from references, employers, and churches listed herein. I also authorize any references, churches, or other organizations or employers listed in this application to give Camp Deer Run any information, including opinions, that they may have regarding my character and fitness for the job I am applying. In consideration of the receipt and evaluation of this application by Camp Deer Run, I hereby, release any individual church, children's organization, charity, employer, reference, or any other person or organization, both collectively and indivually, from any and all liability for the damages of whatever kind or nature which may result to me, my heirs, or my family, on account of compliance or any attempts to comply with this authorization.  

I waive any right that I may have to inspect any information provided about me by any person or organization identified by me in this application. Should my application be accepted, I agree to be bound by the Bylaws and Policies of Camp Deer Run, which are adopted from time to time, and to refrain from unscriptural conduct in the performance of my services on behalf of Camp Deer Run.  

I understand that Camp Deer Run desires to protect its children and therefore give my permission for Camp Deer Run to conduct a criminal background check and to maintain my fingerprints and photo ID on file. I further state that I have carefully read the foregoing release and know the contents thereof and sign this release as my own free act, I understand that any misrepresentation or omission of a material fact on my application my be justification for refusal of employment.  

In the event I am employed, I understand that all employees are subject to termination at the discretion of Camp Deer Run, If, in the event I choose to voluntarily terminate my employment, I am free to do so at any time, and if I choose to give proper notice of termination, Camp Deer Run my either permit me to continue my employment during the notice period or may accept my resignation permanently. I understand that in the event I am employed by Camp Deer Run, my compensation (if any), hours of service, and all other terms and conditions of employment are subject to modification or change by Camp Deer Run at Camp Deer Run’s discretion.  

I understand that, if employed, any misrepresentation made by me completing this application shall be considered as sufficient cause for my dismissal without advance notice. I authorize Camp Deer Run to supply my employment record, in whole or in part, and in confidence to any perspective or future employer, governmental agency, or other party with legal and proper interest therein.  

I hereby give my permission for Camp Deer Run to obtain information relating to my criminal history record. The criminal history record, as received from the reporting agencies, may include arrest and conviction data as well as plea bargains and deferred adjudications. I understand that this information will be used, in part, to determine my eligibility for an employment / volunteer position with this organization. I also understand that as along as I remain an employee or volunteer here, the criminal history records check may be repeated at any time. I understand that I will have the opportunity to review the criminal history and a procedure is available for clarification if I dispute the record as received.  

I, the undersigned, do, for myself, my heirs, executors and administrators, hereby remise, release and forever discharge and agree to indemnify Camp Deer Run and each of the officers, directors, employees, and agents harmless from and against any and all causes of actions, suits, liabilities, costs, debts, and sums of money, claims, demands, whatsoever, and any and all related attorneys’ fees, court costs, and other expenses resulting from the investigation of my background connections with my application to become a volunteer / staff member.  

I hereby authorize to local Police Department and other local, state or federal agencies to release any record that may be on file in my name(s) in the records of said agencies. Any such records will become part of my personal application for employment / volunteer service at Camp Deer Run.  

I also hereby assign and grant to Camp Deer Run as well as their authorized representatives, the right and permission to use and publish the photographs/film/videotapes/electronic representations and/or sound recordings made of me or my child at all activities, and I hereby release Camp Deer Run and all employees, volunteers, related parties, or other organizations associated with the activity from any and all liability from such use and publication. I further authorize the reproduction, sale, copyright, exhibit, broadcast, electronic storage, and/or distribution of said photographs/film/videotapes/ electronic representations and/or sound recordings without limitation at the discretion of Camp Deer Run, and I specifically waive any right to any compensation I may have for any of the foregoing.