Full Application | Columbia Basin Baptist Association

Name (Required)

Email Address (Required)

Camp Touchet Staff/Counselor Application and Child Safety Form (Confidential)

This application is to be completed by all applicants for any position (volunteer or employment) involving the supervision of minor children. This is not an employment application. The purpose of this form is to assist in the creation of a safe environment for children, and students who participate in the programs of Camp Touchet.

Previous Work with Children (Required)

Please list all previous volunteer work or employment (including churches) involving children and students. (List each organization’s name and address, type of work carried out, dates, and a contact person familiar with your work there.

Other Training (Required)

List any talents, vocations, preparation, training, or other experiences which have equipped you to work with children and students.

Family Member Reference (Required)

Include name, email address, mailing address, and phone number. References must include one non-family member and one member of the opposite sex. Please contact these references and inform them an authorized Camp Touchet representative will be contacting them.

Personal Reference (Required)

Include name, email address, mailing address, and phone number. References must include one non-family member and one member of the opposite sex. Please contact these references and inform them an authorized Camp Touchet representative will be contacting them.

Professional or Ministry Reference (Required)

Include name, email address, mailing address, and phone number. References must include one non-family member and one member of the opposite sex. Please contact these references and inform them an authorized Camp Touchet representative will be contacting them.

Because our organization cares for our members and our children and desires to protect them, please answer the following questions. We understand that the answers to the following questions may be private and deeply personal, and we will protect your privacy. If you are uncomfortable answering any of these questions in writing, please contact Bill Lotz (Camp Team Leader) at 509-438-4440 or Macy Carpenter (CBBA Administrative Assistant) at 509-735-4622 for other options.

Why do you want to work with children at Camp Touchet? (Required)

Do you have a preference concerning the age group or sex of children or students with whom you would like to work? Why? (Required)

What is your philosophy concerning re-direction or discipline of children? (Required)

When you are unhappy, angry, or emotional about a person or circumstance, what do you do? (Required)

Have you experienced any significant physical or emotional stresses within the past year, such as the loss of a parent, spouse, or child, extreme ill health, or any emotional or physical crisis? If so, please briefly explain. (Required)

Do you consider yourself to have been physically or sexually abused as a child? (Required)

We realize this information is potentially sensitive, and it will be kept entirely confidential.

Have you ever physically or sexually abused a child? (Required)

Has someone ever accused you of abusing a child? (Required)

Please read the following and type your full name to show your agreement to the following. Your typed name serves as your leagally binding signature. (Required)

I authorize CBBA/Camp Touchet to contact all individuals, organizations, and references listed on this Safety Application Form in order to verify the information I have provided to the organization. I agree to release from liability any person or organization that provides information concerning me, including those persons I have listed as references, as well as contact persons from my previous volunteer work or employment, listed on this application. I specifically authorize Camp Touchet to undertake a criminal background check concerning my past. I understand and agree that any information received from the background check and application verification will not be disclosed to me except as required by law, and I hereby waive any right I may have to inspect any information provided about me by any person or organization identified by me on this form. By signing this form, I certify and affirm that the information I have given on this form is true, complete and correct in all respects.

Volunteer Statements and Agreed Code of Conduct

Please initial each of the following statements and then sign below.

I declare that all statements contained in my Child Safety Application form are true. I understand that any misrepresentation or omission is cause for dismissal. (Required)

I understand that my references and contacts from work with children or students could be contacted and that a thorough criminal background check will be conducted. (Required)

I authorize investigations of all statements contained in this application, and I specifically authorize Camp Touchet to undertake a criminal background check of my past.

I understand that I can withdraw from the application process at any time. (Required)

I understand that Camp Touchet has a policy of ZERO TOLERANCE FOR ABUSE and takes all allegations of abuse seriously. I further understand that Camp Touchet cooperates fully with the authorities to investigate all cases of alleged abuse. (Required)

Abuse of any kind is grounds for immediate dismissal from my volunteer position and for possible criminal charges.

I declare that I am not a pedophile or child molester. I have not perpetrated physical abuse, sexual abuse, emotional abuse, or neglect against a child or student, and I have never been accused of these acts. (Required)

I understand and agree that false statements and/or omissions regarding past conduct and/or present situations may be grounds for denial of this application to provide volunteer services. (Required)

Refusal to inform Camp Touchet of the contents of a sealed criminal record will result in the automatic denial of the application.

If accepted as a volunteer, I agree to read and abide by all Policies and Procedures provided to me by Camp Touchet. (Required)

Type your full name as your legally binding signature, stating that you agree with these volunteer statements and code of conduct. (Required)

Thank you!

If you would like more information on the company we use or how we keep your personal information secure, please visit their website https://ministrysafe.com/ or contact the CBBA office.