WCBC Staff Application

Contact Information

Staff Member Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Cell Phone(Required)

Home Phone

Work Phone

Email(Required)

Gender(Required)

Male

Female

Date of Birth(Required)

MM slash DD slash YYYY

Age(Required)

Last Grade Completed(Required)

Name of Home Congregation(Required)

Are you a first time staff member?(Required)

Yes

Have you been baptized?(Required)

Yes

Medical Information

Please provide us with a copy of your medical insurance card prior to leaving for camp.

Please list any recent injuries, operations or serious illnesses

Are there any medical conditions that we should be aware of or that would prevent you from participating in activities?

Are there any medical, social, mental, or economic problems that the director should be made aware of.

This form will only be viewed by the director, so please explain as best as you can.

Physician Name(Required)

Name

Physician Phone(Required)

Please list any food or medicine allergies.

Please list any other allergies that you have such a bee stings, poison ivy, or other misc items.

Camp Information

It is our desire to provide you with the most wonderful and spiritually uplifting camp experience possible. In order to do that, we need to have open lines of communication.

T-shirt Size(Required)

Youth Small

Youth Medium

Youth Large

Youth XL

Small

Medium

Large

XXL

Do you have any hobbies or interests that would be beneficial at camp?

Please list camp activities that you have helped with in the past.

Please check the areas of camp in which you would like to work or be involved:(Required)

Arts and Crafts

Kitchen Staff

Group Activities

Counselor

Age of Campers - First Choice(Required)

Please note that your first choice of campers would prefer to be with.

Age of Campers - Second Choice(Required)

Please note that your second choice of campers would prefer to be with.

Have you ever pleaded guilty to, or been convicted of, a criminal offense?(Required)

Yes

If yes, please list dates and explain.

Consent(Required)

It is understood that all staff will abide by the rules of the Williamson County Bible Camp and Camp Hy-Lake. If rules are violated, the staff member may be asked to leave.
In case of emergency, I understand every effort will be made to contact family members. In the event that the said applicant becomes seriously ill or is injured while a camper or worker at WCBC then the director or other authorized personnel has our (my) permission to cause to transport applicant to any hospital, emergency room or physician’s office, and I further authorize any qualified medical professional.
physician to administer treatment or surgery.
With my permission given to any hospital or doctor to treat said applicant with whatever treatment necessary, I also agree to assume the responsibility for any expenses involved in these emergency procedures. Failure to check yes or to provide the necessary items will result in you being denied the opportunity to attend WCBC.

I agree to the privacy policy.

Contact Information

Medical Information

Camp Information

Contact Program Staff