Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

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EPIC Staff requires you to attend two staff training sessions prior to camp, via Zoom. You will be required to arrive on Sunday, June 16 to assist with setup. Safe Church training is required ahead of time to work at EPIC. Are you able to commit to this timeframe? *

Yes

No

Are you legally eligible for employment in the United States? *

Yes

No

Have you ever had a substantiated child abuse, child sexual abuse or child neglect case against you? *

Yes

No

Have you ever been convicted of a felony or misdemeanor or do you have charges pending against you? *

Yes

No

Certifications are not required, this section is to gather information. Check the box if you hold current certification:

CPR

First Aid

AED

Lifeguard

Do you have any musical skills?

Guitar 1

Piano

Singing

What activities are you interested in assisting with? *

Outdoor Activities - Choose Your own Adventure/Hiking/Games

Teaching - leading discussion during program time

Arts & Crafts

Leading Worship

What position(s) are you interested in? *

Leadership staff - Program Lead

Leadership staff - Program Chaplain

Program Staff - Support staff

Kitchen - Support staff

Camp Nurse/Dr.

CIT Lead - will assist a Counselor in Training

CIT - Counselor in Training (anyone who just graduated or graduated 1-2 yrs ago)

What age level would you prefer to work with? *

4th-6th

7th-9th

10th-11th

No staff member is guaranteed to have a room to themselves or a lodge room. All staff must be willing to be in a sleep space with campers. Do you agree? *

Yes

No

What is your cabin preference? *

Female

Male

Non-Binary

I agree to have a Background Check completed by the Episcopal Diocese of Iowa. *

Yes

No

I understand Safe Church, Safe Communities training will need to be completed 1 week before EPIC (June 10) 2024.

Yes

No