Staff Participation Staff Participation Form 2022 (This is how I want to serve during camp.) Name: Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Email Sex Male Female Tee-shirt size: Adult Small Medium Large Extra Large Double Extra Large The Board of Directors of Bandina Christian Youth Camp, Inc. requires that all counselors and teachers be members of a congregation of churches of Christ.Please check the following areas according to your areas of interest or ability:I would like to work as a counselor in a cabin with campers. I would like to work in a support role with campers, but not in a cabin with campers. I would like to work in the kitchen as cook _____ or clean up _______. I would like to work in a support role at camp, not directly with campers (maintenance, office) I would like to work as camp nurse and I have the following license or certificate: ___________________. I would prefer to work with _________ age campers. Counselors must be at least 5 years older than the campers they supervise. All cabin counselors also work as either teachers, coaches or in crafts:I would like to work as a morning teacher _____, sports coach ______, or in crafts _______. I would like to work in special activities and games. I would like to work as a lifeguard and have a certification that I will bring with me. The State of Texas requires that all staff be properly trained and oriented for their roles at camp. This training is scheduled for Saturday evening and Sunday morning before camp begins. All staff is required to attend. All staff is expected to be at camp for the entire period, Saturday (July 9 through Saturday (July 16). I will be at camp from Saturday afternoon, July 9, through Saturday noon, July 16, 2022. Each staff person is required to take the Sex Abuse Prevention Course before camp begins (online or in written form). State of Texas regulations require both criminal and sex abuse background checks on all camp personnel.Do you have experience as a camp staff member Where? What staff positions have you filled? Do you currently teach a Bible Class? Yes No What age group? I will never, under any circumstance, strike a child while at camp. I will not use profanity at camp. If I bring a weapon to camp, I will keep it locked in my vehicle and not allow a camper to see or handle it. I understand that Bandina Christian Youth Camp does not allow the use of alcoholic drinks, tobacco products, nor any illegal substance. I understand that the use of these agents will result in my immediate dismissal. I understand that I may not use or have in my possession any alcoholic drinks, tobacco products, or illegal drugs/substances.Signature Reset signature Signature locked. Reset to sign again Date MM slash DD slash YYYY I understand that State Regulations prohibit me from having any medication in my cabin and require that I turn in all prescription and non-prescription medication to the camp nurse upon my arrival at camp to prevent them from being within the reach of campers staying in my cabin (excepting Epi pen and inhalers). I understand that the camp nurse will administer my medication to me as needing during the week of camp.Signature Reset signature Signature locked. Reset to sign again Date MM slash DD slash YYYY Staff forms are due May 15 2022. After that date, applications for new staff members may be considered. Please return the completed forms to Gerald Elliott by U.S. mail, email, or fax: Gerald Elliott Bandina Christian Camp Cell (903)466-6497 1210 N. Riviera Cir Pearland, Texas 77581 Internet Fax: (817) 439-6781 [email protected]