Music and Drama Camp Adult Application - Maranatha Baptist University

Fine Arts: Music and Drama Camp Adult Application

NOTE: Please make sure that you have watched the children's worker video and read the abuse prevention policies before starting to fill out this form.

You will also need the phone numbers and email addresses of your two references.

Basic Information

First Name

Last Name

Phone Number

Your name as you would like it to appear on your nametag:

T-Shirt Size (adult sizes)

Address

Street Address

Address Line 2

City

State / Province / Region

Zip / Postal Code

Country

Select the Adult Camp Opportunity You Desire:

I am an adult providing supervision from 5:00 pm to 8:00 am. I may also desire to participate in a track of my choice during the day. (Pay: Room/Board)I am an adult desiring to stay in the dorms, but do not want to assist with camp in any way (Cost: $100 for Room/Board)I am an adult working as a camp faculty member (by invite only). (Pay: Meals and Small Honorarium)I am an adult participating in a camp track, but not providing supervision from 5:00 pm to 8:00 am. (No cost to participate. Meal Tickets can be purchased at the Dining Complex)I am a Maranatha college student assisting with a particular track during the day and providing dorm supervision in the evening (Pay: Room/Board and $225 towards travel expenses)I am a college student helping in a track during the day, but not staying in the dorms (meals provided).I am volunteering in the Costume Cottage (Room and Board and small honorarium provided).

Select the Camp Track You Prefer:

Please select any that apply

I am CPR certifiedI am CPR and First Aid Basic certifiedI am CPR and First Aid Comprehensive certifiedI do not have any of these certifications up to date.

Which instrument do you intend to play at camp (if applicable)?

Have you played percussion in band or percussion ensemble?

Have you played handbells with Madrigal Choir or another bell choir?

Besides your main instrument, please list the instruments you play and at what level (intermediate/advanced). (Please do not put beginner level instruments.)

Are you a college student?

YesNo

Please express your preferences for helping with evening activities that will possibly be bowling, field games, roller skating, or hiking. Answer like "I love hiking, terrible at skating, ok with bowling, etc."

Select the Academic Credit Option You Prefer. *Please know that application does not automatically equal acceptance.

Music Education: No fieldwork credit available.Piano/String Pedagogy: Fulfills 1 semester of fieldwork (for reporting fieldwork, see pedagogy fieldwork requirements). Piano pedagogy students graduating in less than 8 semesters may substitute a required semester of prep school student teaching with this option (with additional assignments). Obtain permission from Janet Tschida before applying.Any Music Degree Student: Fulfills 1 academic internship credit. No tuition will be assessed for this credit; however, you will need to pay the transcript fee of $25. See music internship course syllabus requirements for additional details. Obtain permission from David Ledgerwood before applying.Drama Productions: Internship in directing, stage work, or costuming (see DP Internship Requirements). Fulfills one required or elective course. Obtain permission from your advisor before applying.No Academic Credit

HOUSING / ROOMING INFORMATION

Will you be staying in the dorms?

YesNo

Will you be staying in the dorm on Sunday night? (We recommend this since you come Sunday night for staff orientation and it's easier to move in Sunday night.)

YesNo

Will you be staying all week for camp through Friday early evening clean-up, or do you have a prior commitment? (VBS, wedding, etc.) Please note that we do depend on camp staff for campus clean-up Friday after the concerts and plays are over. Please answer yes or no and list reasons for no.

Will you be able to stay until 7:00 PM Friday night for camp clean-up? Please carefully consider your schedule as there are ripple effects if you can't.

YesNo

Will you be staying in the dorm on Friday night? Please answer honestly and carefully as we will depend on you with a few campers staying Friday night.

YesNo

If you want specific campers/sponsors in your room, please list their names below:

Arrival:

If I am a dorm counselor, I will arrive no later than 7:00 p.m. (or time TBD) for orientation on Sunday, June 11. If I require an arrival time exception, I have already cleared this with Dr. Bachorik.

Orientation:

I will attend camp staff orientation (7:45 for 8:00 p.m.) ALL staff except Costume Cottage volunteers.

Children's Worker Video:

I have watched and understand the updated 2015+ edition of the Maranatha children's worker video. This video is available on the main camp page in the drop-down under "All Adults Involved with Camp"

Children's Worker Policies:

I have reviewed and understand the updated 2015+ edition of the Maranatha children's worker rules. This information is available on the main camp page in the drop-down under "All Adults Involved with Camp"

REFERENCE CHECK

Agreement to Abide by Policies:

I agree to abide by the children's worker rules and leadership instructions in my service with children on the behalf of Maranatha.

Reference Check Consent:

I agree to a reference check.

Reference 1 Information

First Name

Last Name

Phone Number

Relationship To You

Reference 2 Information

First Name

Last Name

Phone Number

Relationship To You

BACKGROUND CHECK RELEASE FORM

Background Check Consent

I agree to a background check. PLEASE NOTE: You will receive an email to the address listed above within the next several days from Maranatha. This email will contain a link to a secure online form provided by ScreeningONE. The link will remain active for 14 days. We request that you complete the form at your earliest convenience.

NOTIFICATION AND RELEASE

Maranatha Baptist University & Seminary

745 West Main Street, Watertown, WI 50934

The information contained in this Notification and Release is for use in my role working and/or volunteering with minors at Maranatha Baptist University & Seminary (hereinafter, “Maranatha”) and is true to the best of my knowledge and belief. I understand that any misrepresentation or false statement made by me in connection with this Notification and Release or any related documents which is deemed material by Maranatha shall result in Maranatha declining use of my services or requesting my dismissal from Maranatha-sponsored camps and events. I understand and agree that all information furnished may be verified by Maranatha or its authorized representative. I hereby acknowledge that I have been informed by Maranatha that Maranatha may seek to obtain an investigative report that will include personal information regarding me, including but not limited to, educational history, work references, driving record, drug testing and criminal convictions or arrest records if allowed, in order to assist Maranatha in making certain decisions. I further acknowledge notification by Maranatha that reports may be provided to Maranatha by other firms subcontracted for that purpose. I, my heirs, assigns and legal representatives, hereby release and fully discharge Maranatha, its parent and affiliated companies and the respective officers, directors, shareholders, employees, agents of each, including subcontractors, from any and all claims, monetary or otherwise, that I may have against Maranatha, its parent, affiliates or subcontractors, arising out of the making, or use of, an investigative report, including any errors or omissions contained or omitted from such reports or investigations. Maranatha agrees to inform you if the decline of your services has been influenced by information contained in such reports.

SIGNATURE

By signing this form, I agree to fulfill the camp staff requirements if I qualify and am selected for this position.

Online Signature

Today's Date (MM/DD/YYYY)