Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Date of Birth *

Month, day, year - sorry!

MM

DD

YYYY

Gender *

Female

Male

Other

Summer camp work involves close contact with children. Have you ever been investigated, arrested or convicted of Child Abuse, Neglect or Related Charges? *

Yes

No

Have you ever been convicted of any other criminal activity? *

(An arrest or criminal record does not automatically disqualify a candidate; each person is evaluated based upon individual circumstances.)

Yes

No

Are you willing for us to conduct an enhanced DBS check? *

Yes

No

Camp work entails physically demanding activity including but not limited to hiking, running (during games), lifting and carrying. Do you have any physical limitations that would prevent you from performing the work for which you are being considered? *

Yes

No

Please confirm *

I certify that all information given on this application is true. I understand that misrepresentation or omissions of facts can be cause for dismissal. I agree to abide by all policies, rules and regulations of Camp Crusoe. I authorise Camp Crusoe to conduct an enhanced DBS check should one be required.