Section 1: Personal Information Legal Name*
First
Middle
Last
Maiden Name
Last
Date of Birth* SSN*
Address*
Phone*
Email*
Shirt Size*
Marital Status*
Spouse Name
Will your children attend camp?* Present Employer*
Do you have a CDL?* Are you available if we need a driver?* Do you have a current First Aid Certification?* Are you CPR Certified?* Are you certified for food preparation?* Emergency Contact*
First
Last
Emergency Contact Phone*
Any allergies? If so, list them below.
Any medications? If so, list them below.
Section 2: Criminal Records Release Form Criminal Records Release Form* In connection with this application for volunteer service with the House of Prayer Ellettsville, this is to inform you that a criminal background check will be conducted with all law enforcement agencies.
I authorize, without reservation, any person, agency or other entity contacted by House of Prayer Ellettsville, and any investigative services and their agents, to furnish the above-mentioned information.
I release House of Prayer Ellettsville, any person or agency, their respective employees, agents, volunteers, and all persons providing information or reports about me from any and all liability arising out of the release of any such information or reports.
*Please note: We are concerned about extreme crimes, especially those committed against children. These reports will be covered by the Kids Camp Funds provided and will be of no cost to you.
ALL INFORMATION IS ACCURATE TO THE BEST OF MY KNOWLEDGE.
e-Signature: Full Name Type in your name.
e-Signature: Date*
MM slash DD slash YYYY
Type in today's date.
Section 3: Ministry Agreement House of Prayer Ellettsville Ministry Agreement* We believe that to carry on the religious mission of the church, to preserve the function and integrity of the church as the local Body of Christ, and to provide a biblical role model to the church members and the community, it is imperative that all persons who associate with the church as members should abide by and agree to the following statements and conduct themselves in accordance with them.
A. Statement of Faith
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We believe as indicated in our Statement of Faith as follows:* ARTICLE VI
STATEMENT OF FAITH
Section A: NATURE AND PURPOSE OF THE STATEMENT OF FAITH: This doctrinal statement is not a
creed. The whole Bible is our only creed. However, we are keenly aware of the existence of many diverse doctrinal
interpretations among Christians. We are also convinced that to avoid a looseness which could result in the
admission to our membership of an unbeliever, or of Christians who are not prepared to cooperate in the
fellowship and the work to which God has called us, certain minimal basic, and scriptural truths must be
recognized and subscribed to.
Section B: STATEMENT OF FAITH
1. We accept the scriptures of both the Old and New Testaments to be the divinely inspired Word of God, and
that the scriptures are the supreme and final authority for our faith and practice.
2. We believe that the eternal and pre-existent God, manifests himself as God the Father, God the Son, and God
the Holy Spirit and these three are one God, according to Deut. 6:4 – Mark 12:29-30 --and Eph. 4.
3. We believe in the incarnation and virgin birth of Jesus, in his sinless life and in the sufficiency and
substitutionary nature of his death on the cross for the sins of the world, in his bodily resurrection from the dead,
and in his ascension to heaven. We anxiously await his bodily return to earth to set up his millennial kingdom
after the tribulation period. We also believe that Christ by His Holy Spirit, now indwells all believers as the living
and ever-present Lord of our lives.
4. We believe that men are justified by faith alone, and that they are accounted righteous before God only through
the merit of the Lord Jesus Christ. Salvation is thus by grace and through the faith in the shed Blood of Jesus
Christ.
5. We believe in sanctification through the Word of God, by the Holy Spirit, and in personal holiness of heart and
life. "For we are his workmanship, created in Christ Jesus unto good works, which God hath before ordained that
we should walk in them." (Eph. 2: 10)
6. We believe in water baptism, in the baptism and fullness of the Holy Spirit, in the gifts of the Spirit and in the
evidence of the fruit of the Spirit
7. We believe that such, only are true believers as endure unto the end. That their persevering attachment to Christ
is the grand mark which distinguishes them from superficial professors of the faith. That a special providence
watches over their welfare; and that they are kept by the power of God, through faith, unto salvation
8. We believe in the bodily resurrection of believers to everlasting life and fellowship with God. We also believe
in the bodily resurrection of all nonbelievers to everlasting torment and punishment in Hell's fire.
9. We believe that God's plan for this present age involves the evangelization of the world through the witness of
every believer in Jesus Christ, and the establishing of local churches as a means of accomplishing his purposes.
10. We believe that a New Testament Church is a local fellowship of baptized believers who are associated by
faith and fellowship of the Gospel, observing two ordinances of Christ (water baptism and the Lord's Supper),
committed to his teachings, exercising the gifts, rights, and privileges vested in them by his Word, and seeking to
extend the Gospel to all people. This church is under the Lordship of Jesus Christ and the authority of his Word.
11. We believe that God wonderfully and immutably creates each person as male or female, and that these two
distinct, complementary genders together reflect the image and nature of God. We believe that God created
marriage to be exclusively the union of one man and one woman, and that intimate sexual activity is to occur
exclusively within that union.
12. We believe that all human life is sacred and created by God in His image. Human life is of inestimable worth
in all its dimensions, including pre-born babies, the aged, the physically or mentally challenged, and every other
stage or condition from conception through natural death. We are therefore called to defend, protect, and value
all human life. (Ps 139.)
The New Testament also speaks of the church at large as being the body of Christ, which includes all the
redeemed of the ages. Thus, we believe in the church invisible and universal
Final Authority for Matters of Belief and Conduct
The statement of faith does not exhaust the extent of our beliefs. The Bible itself, as the inspired and infallible
Word of God that speaks with final authority concerning truth, morality, and the proper conduct of mankind, is
the sole and final source of all that we believe. For purposes of the Ellettsville House of Prayer’s faith, doctrine,
practice, policy, and discipline, our Board of Elders is the Ellettsville House of Prayer’s final interpretive authority
on the Bible’s meaning and application.
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B. Statement on Church Discipline* The threefold purpose of church discipline is to glorify God by maintaining purity in the local church (1 Cor 5:6),
to edify believers by deterring sin and promoting purity (1 Tim 5:20), and to promote the spiritual welfare of the
offending believer by calling him or her to return to a biblical standard of doctrine and conduct (Gal 6:1).
The Lord Jesus Christ has entrusted the local church with the authority and responsibility to discipline members
for flagrant sin or serious doctrinal error, with the goal of the restoration of the offender. This discipline is
entrusted to the Pastoral Staff and the Board of Elders and is to follow the biblical pattern as set forth in Matthew
18:15-20; 1 Corinthians 5; 2 Corinthians 2:7-8; Galatians 6:1; 2 Thessalonians 3:6; Titus 3:10-11; and 2 John 7-
11. Any member of this church who practices or affirms a doctrine or conduct that, in the judgment of the Pastoral
Staff and Board of Elders, is opposed to the teaching of the Word of God, or is threatening to the testimony of
this church, or is divisive to the body, shall be subject to church discipline.
Discipline will follow the said biblical pattern and is an effort to bring the individual to repentance and protect
the church from unrepentant sin. Discipline may involve exclusion from participation in ministry and communion,
as well as dismissal from the fellowship of this church. An individual may be disciplined by the Pastoral Staff
and Board of Elders short of dismissal from the fellowship, as they deem appropriate for the specific circumstance
(for example, an individual may remain in certain circumstances a member of this church but be denied the
privilege of serving in a particular ministry).
The Pastoral Staff and Board of Elders, as is required by Scripture, may report to the congregation the names of
those who have lost membership by reason of church discipline, and the reason for that discipline, as described
in Matthew 18:15-20.
The members of this church further knowingly and voluntarily agree that a member cannot voluntarily withdraw
or resign his or her membership in the midst of the discipline process, and may only voluntarily withdraw or
resign his or her membership if they are not the subject of a discipline proceeding at the time or only after a
disciplinary process, of which they are the subject, has been concluded as determined by the Pastoral Staff and
Board of Elders.
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C. Statement on Mediaton* Members of the church agree to submit any legal dispute with the church for mediation before a mutually agreedupon mediator. Lawsuits between believers, or threats of lawsuits between believers, are a matter of grave concern
for the church, are contrary to biblical and church teaching, and mediation is an effort to resolve disputes in a
biblical fashion. (1 Cor 6: 1-7.)
The confidentiality of the mediation process will be protected, and these matters will not be discussed with people
who do not have a necessary interest in them. If settlement can be agreed upon, the conciliators may, at their
discretion, issue an advisory opinion. Neither the opinion, nor any communications exchanged in the mediation
process, will be admissible for any purpose in any subsequent legal proceeding.
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D. Statement on Life* We believe that all human life is sacred and created by God in His image. Human life is of inestimable worth in
all its dimensions, including pre-born babies, the aged, the physically or mentally challenged, and every other
stage or condition from conception through natural death. We are therefore called to defend, protect, and value
all human life. (Ps 139.)
Type your initials below:
E. Statement oF Final Authority on Matters of Faith and Conduct* The statement of faith does not exhaust the extent of our beliefs. The Bible itself, as the inspired and infallible
Word of God that speaks with final authority concerning truth, morality, and the proper conduct of mankind, is
the sole and final source of all that we believe. For purposes of the Ellettsville House of Prayer’s faith, doctrine,
practice, policy, and discipline, our Board of Elders is the final interpretive authority on the Bible’s meaning and
application.
I have reviewed the statements above as indicated by my initials before each of them and agree to be
governed by all the provisions herein. I understand that this agreement must be renewed annually. I
understand that only members in good standing (not currently in a disciplinary process) with a current
unexpired Membership Agreement will be permitted to minister or serve in any capacity.
Type your initials below:
e-Signature: Full Name Type in your name.
e-Signature: Date*
MM slash DD slash YYYY
Type in today's date.
Section 4: Waiver Consent Form HOPE Ministries Kids Camp Rules & Regulations* Matthew 18:15-17a says, “Moreover if your brother sins against you, go and tell him his fault between YOU AND
HIM ALONE. If he hears you, you have gained your brother. But if he will not hear, take with you one or two
more, that ‘by the mouth of two or three witnesses every word may be established’ (Deut. 19:15). And if he refuses
to hear them, tell it to the church.” (bring the matter to the pastor)
We expect ALL participants to respect what God’s Word says about resolving conflict. Anyone participating
in Kids Camp at the House of Prayer are expected to follow these guidelines if any conflicts arise. Failure to do so,
in a Godly manner may result in being asked to leave the camp.
The usage policies of HOPE Kids Camp are to ensure your safety and the safety of others, and to promote
stewardship and responsibility.
1.No tobacco or alcoholic beverages consumed or permitted on the property.
2. No pets allowed on the property. Do not feed stray animals.
3. Linens and pillows are not provided. You need to bring your own sleeping bag, pillow, towels, soap and
personal toiletries. (Overnight staff and teens only.)
4. Do not fasten (tie, tape, mark on, paste, pin or staple) anything to walls, doors, ceilings or furniture. Use of candles in any building not permitted.
5. Liquid waste should NOT be thrown into trash bags.
6. Adult supervision of children required at all times.
7. ONLY adult leaders will handle fire tending. Campfires are in designated areas only, totally extinguished when
done.
8. The homes surrounding the HOPE are private residences and the land they are on is private property owned by
others. Groups should stay on the camp property.
9. The cutting, digging up or picking of any live plant, tree, or flower is forbidden.
10. No driving or parking on grass without prior permission.
11. Camp property and equipment are to be used for their intended purpose only. Please do not use property as
props for games and skits.
12. Dress of Campers and Camp Helpers will be conservative and will reflect the values of the HOPE and our
Lord, Jesus Christ.
13. Swimming Attire, when applicable, will be modest. Girls in One-piece suits, Boys in long swim shorts.
14. Soiled shoes and wet clothing should not be worn inside on the carpeted areas. Wet clothes need to be hung
outside until dry.
15. Pay close attention to the cleanliness of the facilities when you arrive. You will be expected to leave the
facilities in the same condition as you found them. (or better)
16. Use of church telephone is not permitted without permission from a pastor.
17. If you need to reach a camper during Kids Camp, please call the church office 876-9002 x109
18. House of Prayer will not be held liable for accidents occurring while attending HOPE Kids Camp.
Waiver Consent for all HOPE Kids Camp Participants and Volunteers:
In consideration of good and valuable consideration the receipt and adequacy of which is acknowledged,
I, the undersigned agree to release HOPE Kids Camp (AKA: Circle J, Circle J Ranch, hereafter referred as HOPE
Kids Camp) House of Prayer Ellettsville (“Event Coordinator”) from any claims, demands, rights, or causes of
action of whatsoever kind or nature, arising from, or by reason of, any and all known or unknown, foreseen or
unforeseen bodily or personal injuries, damage to property, and the consequences thereof, which may hereafter
be sustained by me in connection with my participation or attendance at the HOPE Kids Camp. The Event
Coordinator does not take any responsibility for my involvement as a Participant or Volunteer in the Camp. I am
responsible for my own safety and insurance. By execution of this Consent I agree to hold and save the Event
Coordinator harmless from and against any liability, loss or damage, to the full extent thereof, and from and
against all costs and expenses (including attorney’s fees), hereafter incurred or suffered by Event Coordinator by
reason of the existence of any claim, liability, loss or damage of any kind or nature arising out of my participation
as a Participant or Volunteer of the HOPE Kids Camp. This obligation to indemnify shall include the retention of
reasonable legal counsel, investigation costs and all other reasonable costs and expenses and liabilities from the
first notice that any claim or liability, which is the subject of this indemnity, is to be made or may be made.
I agree that any legal disputes regarding this agreement shall be settled in Monroe County, Indiana.
e-Signature: Full Name of Parent / Adult Volunteer Type in your name.
Section 5: Photo / Video Release Form Photograph / Video Release Form* Photographic, audio or video recordings may be used for ANY USE which may include but is not limited to:
• Presentations;
• Courses;
• Online/Internet Videos;
• Media;
• News (Press);
By signing this release, I understand this permission signifies that photographic or video recordings of me may
be electronically displayed via the Internet or in the public educational setting.
I will be consulted about the use of the photographs or video recording for any purpose other than those listed
above.
There is no time limit on the validity of this release nor is there any geographic limitation on where these materials
may be distributed.
This release applies to photographic, audio or video recordings collected as part of the sessions listed on this
document only.
By signing this release, I acknowledge that I have completely read and fully understand the above release and
agree to be bound thereby. I hereby release any and all claims against any person or organization utilizing this
material for educational purposes.
e-Signature: Full Name Type in your name.
e-Signature: Date*
MM slash DD slash YYYY
Type in today's date.
e-Signature: Parent's Name If this release is obtained from a presenter under the age of 19, then the signature of that presenter's parent or legal guarding is also required. Type in the parent's full name.
Section 6: Availability Availability* Please let us know which hours and on which days you are available. Day options are: Saturday for set up, Monday, Tuesday, Wednesday, Thursday, Friday, Saturday for clean up.
Camp Areas* Please read the following descriptions of the numerous areas of camp. From there, please write your preferred areas to work in by listing them 1st choice, 2nd choice, and 3rd choice. A scene leader from your area will contact you as camp approaches to answer any additional questions you might have.
Counseling Department - Head Counselor
To lead my group as a Godly example, to be able and willing to delegate jobs to my assistants, to have fun with the kids / teens / adults and make kids camp a memorable experience for everyone. Head counselors should be eager and able to lead campers to salvation and to "disciple" and counsel them as needed.
Counseling Department - Assistant Counselor / Teen Counselor
To serve my head counselor immediately, sweetly, and completely! I will have a good attitude, remembering that I am doing this for the kids. I will be willing to help out and make my leader's job easier. I will be ready to take charge of fun time with my team.
Kitchen
Cooking, cleaning, and serving is part of my job. I will show up at my designated time. I will be ready to serve the campers and my leader with a smile on my face. Plus - it is in the air conditioning!
Horse Camp
Cleaning, caring, and helping with the horses. I will also help the children on the horses and be able to walk the distance of the trail. I will show up at my designated time and be ready to serve. I understand that I will get dirty and this job requires boots.
Indiana Encampment
When in the encampment I will be in costume and in character. I will be prepared for what we will be doing each day and be flexible enough if there are lots of kids present at one time by having extra information and activities to keep the kids busy and interested.
Cowboy Camp
When in the encampment I will be in costume and in character. I will be prepared for what we will be doing each day and be flexible enough if there are lots of kids present at one time by having extra information and activities to keep the kids busy and interested.
Fort Friendly
When in the fort I will be in costume and in character. I will be prepared for what we will be doing each day and be flexible enough if there are lots of kids present at one time by having extra information and activities to keep the kids busy and entertained.
Townspeople
This includes the JAIL and MERCANTILE areas of camp as well as the general camp townspeople. I will be in costume and in character at all times. I will be prepared for what we will be doing each day and be flexible enough to help as many kids are present at one time.
Andy's Place
I will be helping with paintball, arrows, and other objects. I understand the responsibility that comes with this area of camp which means I will be diligent to keep my attention focused on the children to maintain safety at all times.
Pottery
I will be in costume and in character at all times. I will be prepared for what we will be doing each day and be flexible enough to help as many kids are present at one time.
Critter Coral
I will be in costume and in character at all times. I will be prepared for what we will be doing each day and be flexible enough to help as many kids are present at one time.
Gold Panning
I understand the responsibility that comes with this area of camp which means I will be diligent to keep my attention focused on the children to maintain safety at all times.
Blacksmith
I understand that I will be in costume and in character during camp. I will be prepared for what we will be doing each day and be flexible enough if there are lots of kids present at one time by having extra information and activities to keep the kids busy and interested.
Ice Cream
I will help children with the ice cream machine and/or
getting ice cream from the freezer. I will coordinate with
office staff to ensure that enough ice cream is being ordered daily and keep a daily record of ice cream used.
Runner
I will run errands for camp in my designated areas. I will be willing and able to pull trash in camp areas, deliver water to each area on campus, check the shower house for cleanliness, etc. and whatever else I may be asked to do.
Cleaning and Laundry
I will help with cleaning and laundry services as needed around the camp.
Camp Photographer
I will dress in appropriate time era outfit or designated photographer shirt as requested by camp foreman. I will adhere to the photography standards set forth by the foreman and church administration regarding photographing campers, volunteers, and staff.
Registration
I will help with the registration and pick up of children in the morning or in the afternoon. I will help to create a friendly and calm experience for parents and children who are coming to camp and will keep a good attitude.
Before and After Care
I will help supervise the children before or after camp. I will focus on ensuring the safety and well being of the children and will work closely with the registration team in order to make the process as calm and seamless as possible.
Nursing Staff
I will provide nursing care to the campers and volunteers as
needed. I will oversee medication and allergy concerns for all campers. I will report to Camp Foreman(s) for all
concerns relating to the children as required.
Friday Special Activities
I will help plan, set-up and supervise field games and special activities on Friday.
ANYWHERE NEEDED!
I am excited about being a part of Circle J Kids Camp and am willing and able to help out in whichever area I am assigned. I will exemplify a Christ-like countenance to everyone whom I come in contact.