Name

Gender

Male
Female

Age

Date of Birth

Phone Number

Address

T-Shirt Size

Have you accepted Jesus Christ as your Lord and Savior?

Have you been baptized?

Please tell us about your current spiritual walk

Why do you want to serve at camp?

What experience do you have working at a camp and or with youth?

Do you feel comfortable talking to youth about Jesus? Explain Why.

Do you feel comfortable leading a small group or a devotion?

Do you feel comfortable leading others in prayer?

Are there any talents, experiences, or interests you can bring to camp? What area do you feel most comfortable leading or helping lead?

Your Church Info

Church Name

Pastor's Name

Church Phone Number

Which camp(s) are you applying to be a mentor for?

Sr High Mentor

must be 21 or older

Jr High Mentor

must be 18 or older

Kids Mentor

must be 18 or older

Kids MIT

Mentor In Training

KY State Youth Camp Statement of Faith

Doctrinal Statement of Faith

● We believe in one God – Father, Son and Holy Spirit (Matthew 3:16 & 17; John 14:9 & 10)

● We believe God is the Creator of man and of all things (Genesis 1:1; Acts 17: 24-28)

● We believe in Jesus Christ, God’s only Son and Savior of the world. (John 3:16; Matthew 1:18; John 20:24-31)

● We believe the Holy Spirit dwells within every Christian. (John 16:5-15)

● We believe the Bible is the inspired word of God and the final authority for all matters of faith. (Romans 15:4; Hebrews 4:12; 2 Timothy 3:16)

● We believe that man, created by God, willfully sinned and, as a result, is lost and without hope apart from Jesus Christ. (Acts 4:12; Romans 3:23; 1 John 1:7)

● We believe that salvation (the forgiveness of sins) comes by grace through the blood of Jesus Christ (his death on the cross). (Matthew 26:28; Romans 5:8-11; Ephesians 2:8-9)

● We believe the Bible teaches that the pattern to follow to receive Jesus as Savior is to believe in Christ as God’s Son and Savior of the world, to repent of personal sin, to confess Christ as Lord, and to be immersed in baptism. (Luke 24:45-57; Acts 2:38; Romans 6:1-7; 2 Peter 3:9)

● We believe that the church is the body and bride of Christ, founded on the day of Pentecost, consisting of all Christians everywhere. (Matthew 16:13-18; Acts 2:14-47)

● We believe it is God’s plan for the pastors to shepherd the local church. (Acts 20:28; 1 Timothy 3:1-7; 1 Peter 5:1-4)

● We believe that death seals the eternal destiny of each person. The saved will inherit eternal life; the unsaved, eternal separation from God. (Romans 8:10-11; Daniel 12:2; John 6:47)

Volunteer Committment

As a Volunteer Staff Member at KY State Youth Camp:

1. I agree to submit to the authority of the leadership of the KY State Church of God in matters of doctrine. (Doctrinal Statement above)

2. I willingly submit to director, of the camp in which I will be volunteering.

3. I agree to be consistently present at my time of volunteer service and to arrive at the appropriate time appointed by the director (Matt 5:37).

4. I commit to taking potentially divisive issues directly to the director of the camp. (2 Tim 2:14).

5. I agree to participate in any meetings and/or training necessary when required.

6. I agree to serve with all my heart the camp in which I am serving (Colossians 3:23 NIV)

7. I understand that as a volunteer leader involved at camp, I publicly represent the camp and will use proper judgment in matters of lifestyle, sexuality, character, and integrity. In so doing, I agree to avoid matters which may reflect an appearance of evil (1 Thessalonians 5:22).

8. I understand that as a volunteer leader involved at camp, I publicly represent the camp and support the statement that sexual relations are God’s gift to be enjoyed exclusively in the context of a marriage between one man and one woman. All other sexual relationships are outside of God’s will for mankind.

9. I agree NOT to promote or distribute any form of alcohol or any type of illegal drugs at camp.

Volunteer Committment

I am signing to acknowledge that I have read and understand what is expected of me as a volunteer leader at KY State Youth Camp(s) as outlined above.

I, the undersigned, agree to the terms above.

Background Check Information

Pursuant to KRS 17.160, a request if made for any record of conviction of a crime in KRS Chapter

531, 510, 218A, and 189A by the person identified herein.

This information shall be released to:

Kentucky Church of God Ministries, 2494 Colby Road, Winchester, Kentucky 40391

Discrimination Statement:

“The information on this form is required for identification purposes for background screening processing only and is in no manner used as qualifications for credentialing. The General Assembly of the Church of God, and the Credentials Committee do not discriminate on the basis of sex, race, religion, age (40 and over), handicap, or national origin.”

I have read and agree to the terms above.

Confidentiality Statement:

“All information gathered in the process of credentialing will be maintained in secured, confidential files and will be made available only to authorized credentials personnel at Kentucky Church of God Ministries and, in the event of transferring credentials, to the transferring state’s Church of God credentials office. This confidentiality may be breached only with the consent of the applicant, or when there appears to be clear and imminent danger to the applicant, others, or society.”

I have read and agree to the terms above.

Background Check Authorization

Authorization: During the application process at Kentucky Church of God Ministries, I hereby authorize Kentucky Church of God Ministries, on behalf of The General Assembly of the Church of God, to procure a consumer report which I understand may include information regarding my credit worthiness, credit standing, credit capacity, character, general reputation, personal characteristics, or mode of living. This report may be compiled with information from credit bureaus, courts record repositories, departments of motor vehicles, past or present employers and educational institutions, governmental occupational licensing or registration entities, business or personal references, and any other source required to verify information that I have voluntarily supplied. I understand that I may request in writing a complete and accurate disclosure of the nature and scope of the background verification; to the extent such investigation includes information bearing on my character, general reputation, personal characteristics or mode of living.

I, the undersigned, agree to the terms above.

For privacy and security, in order to complete the background check you will receive an email from Ministry Safe, this is the company who performs the background checks for KY State Church of God. You must respond to this email in order for the background check to be completed. This will allow you to fill in your personal information like driver's license and social security # so they can complete the background check but you do not have to fill in your personal information here.

After the background check is complete you will also receive a link to complete a required training.

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