PO Box 445, Glendon, AB T0A 1P0
Email: [email protected]
780-635-2484 (May 15-Sep 15 only)
COUNSELLOR APPLICATION
KIDS CAMP, JULY 5-10, 2015
Type of People Wanted:
1. Actively growing in their faith.
2. Have a servant’s heart and are willing
to work hard.
3. Strong witnesses for Christ and
examples of consistent Christian
living.
4.
Have a sincere love for children.
5. Have a desire and ability to share the
Christian message.
6.
Team members because teamwork is
at the heart of everything we do!
Please fill out this application and have your pastor complete the reference form (last page
of this form) and mail it to our office by June 1, 2015. Please call after the deadline to see if
space is still available. Application MUST be completed in full to be processed.
All information is strictly confidential and only persons with legitimate need will have access to any
information obtained in the application process. Failure to complete any or all of the application may
delay consideration. Any questions of a sensitive, personal nature may be reviewed by the applicant
with a senior minister in advance of completion.
1. Who Are You?
Position Applying for: o Counsellor
Preferred Age Group: o Gr. 1-2
o Gr. 3-4
Name:
o Gr. 5-6
o Mr. o Mrs. o Miss
Address:
Date of Birth:
/
/
Day / Month / Year
City:Postal Code:
Purpose of this Form
Moose Lake Pentecostal Camp has
a spiritual, moral and legal obligation
to provide a secure environment
for children participating in camp
programs and who are under the
auspices of the camp.
Telephone Home: (
)
Cell: (
)
Email:
Home Church:Pastor:
How long have you attended this church?
Church Phone #: (
)
In case of emergency contact:
Relation:
Phone: (
)
2. Medical
Date of Last Tetanus:
AHC #:
Are there any medical concerns we should be aware of:
List any allergies as well as severity of each.
Are you presently on any medication?
If yes, please indicate what:
o Yes
o No
...please complete reverse
Your Chance For An Eternal Impact!
We need counsellors with the desire and ability to minister to the children of today!
3. Why You?
6. References
Why do you want to be a counsellor?
Please provide two (one must be a pastor)
references:
How do you think you could help change a child’s life at camp?
1.Name:
If you are a returning volunteer, tell us why you want to return to be a counsellor at kids camp?
4. Personal History
Because of the innocent nature of children, we have the highest standard for their caregivers. Therefore, the following questions are of a personal nature. We ask you to answer them honestly. If you
prefer not to answer these questions, we request that you discuss them with a pastor.
Relation:
Daytime Phone: (
)
Address:
City:
Prov.:
PC:
Email:
Are you currently involved in any of the following activities, or have you been involved in them within
the past 5 years?
o Use of tobacco
o Illicit sexual behaviour
o Use of illegal drugs
o Use of pornography
o Drinking of alcoholic beverages
o Abusive behaviour
2.Name:
Do you have a criminal record or have you ever been convicted of a criminal offence? o Yes o No
If yes, explain.
Address:
Each counsellor, upon acceptance, will be responsible for obtaining a criminal record check. Are you
prepared to consent to a criminal-records search? o Yes o No If not, please explain.
Email:
Relation:
Daytime Phone: (
City:
)
Prov.:
PC:
7. Statement
Have you had any painful experiences in your life that have better equipped you or may hinder you
from a productive ministry to kids? o Yes o No If yes, please explain.
I certify that the information contained herein
is correct. I authorize any references listed to
provide any information requested pertaining
to my character and fitness to participate in a
leadership role at camp.
5. Church and Ministry History
Should my application be accepted, I agree
to be bound by the constitution, policies
and procedures of Moose Lake Pentecostal
Camp, including discipline processes, and to
refrain from any conduct unbecoming in the
performance of my responsibilities on behalf of
the camp.
My current ministry involvement is:
List all previous work involving children (identify organization, type of work).
List any gifts, calling, training, education, or other factors that have prepared you for ministry to
children.
Our camp adheres to the Statement of Faith of the PAOC. This includes the belief that "The baptism
in the Holy Spirit is an experience in which the believer yields control of himself to the Holy Spirit.
Through this he comes to know Christ in a more intimate way, and receives power to witness and
grow spiritually. Believers should earnestly seek the baptism in the Holy Spirit according to the command of our Lord Jesus Christ. The initial evidence of the baptism in the Holy Spirit is speaking in
other tongues as the Spirit gives utterance. This experience is distinct from, and subsequent to, the
experience of the new birth."
Do you agree with this statement?
o Yes o No
I am willing to prepare myself, to act in the best
interest of the campers under my care at all
times, to cooperate with the camp leadership
and to give my 100% best as part of the camp
ministry team. I will do my utmost to fulfil
my obligations and will uphold the rules and
testimony of the camp.
Applicant's Signature:
Dated at
this
day of , Alberta,
2015.
How long have you been a born-again Christian?
Please give a brief testimony of your salvation experience (Including when you were saved and your
spiritual growth since that time. Attach separate page if necessary.)
Camp Dates
Our kids camp dates are July 5-10 and the
counsellors are required to be at the camp by
12:00 noon on July 5.
Directions to Camp
Moose Lake Pentecostal Camp is located
between Glendon and Bonnyville, Alberta
on the west end of Moose Lake at 61025
Range Road 474. A map is available at
www.mooselakepc.ca.
MLPC Kids Camp Counsellor
July 5-10, 2015
Volunteer Ministry Commitment
Our Vision
Our vision for kids camp is to provide an opportunity for kids to receive Christ, nurture a desire for a lifelong relationship with Him, and to develop a hunger for the presence of God through a tangible and reallife experience with Him. It is a time to build friendships and mentoring relationships that have the potential
to last a lifetime.
What We Believe
ABOUT GOD
God is the creator and ruler of the universe. He has eternally existed in three persons – the Father, the
Son, and the Holy Spirit. These three are co-equal and are one God.
ABOUT MAN
Man is made in the spiritual image of God, to be like Him in character. He is the supreme object of God’s
creation. Although man has tremendous potential for good, he is marred by an attitude of disobedience
towards what God calls “sin.” This attitude separates man from God.
ABOUT ETERNITY
Man was created to exist forever. He will either exist eternally separated from God by sin or in union with
God through forgiveness and salvation. To be eternally separated from God is hell. To be eternally in union
with Him is eternal life. Heaven and hell are places of eternal existence.
ABOUT JESUS CHRIST
Jesus Christ is the Son of God. He is co-equal with the Father. Jesus lived a sinless human life and offered himself as the perfect sacrifice for the sins of all men by dying on a cross. He arose from the dead
after three days to demonstrate His power over sin and death. He ascended to heaven’s glory and will
return again to earth to reign as King of Kings and Lord of Lords.
ABOUT SALVATION
Salvation is a gift from God to man. Man can never make up for his sin by self-improvement or good
works – only by trusting in Jesus Christ as God’s offer of forgiveness can man be saved from sin’s penalty.
Eternal life begins the moment one receives Jesus Christ into his life by faith.
ABOUT THE HOLY SPIRIT
The Holy Spirit is equal with the Father and the Son as God. He is present in the world to make men
aware of their need for Jesus Christ. He also lives in every Christian from the moment of salvation. He
provides the Christian with power for living, understanding of spiritual truth, and guidance in doing what is
right. The Christian seeks to live under His control daily.
ABOUT THE BIBLE
The Bible is God’s word to all men. It was written by human authors, under the supernatural guidance of
the Holy Spirit. It is the supreme source of truth for Christian beliefs and living. Because it is inspired by
God, it is truth without any mixture of error.
ABOUT BAPTISM
Baptism by immersion symbolizes the death, burial, and resurrection of Jesus and is your public declaration that you have accepted Jesus Christ as your personal Saviour. Baptism does not save you, but shows
the world that you have already been saved. And while baptism is not required for salvation, it is a biblical
command and demonstrates your love and obedience to Christ.
MLPC Kids Camp Counsellor
July 5-10, 2015
Volunteer Ministry Commitment
As a counsellor at MLPC Kids Camp, I understand that I am a spiritual leader and an example to other campers. By
taking part in this ministry, I am aware that my life makes a statement not only about who I am, but about my relationship
with God. I am committed to choices and a lifestyle that are both godly and “above reproach” knowing that my lifestyle is
a model for the campers I am responsible for. I also recognize that this is about ministry for the kingdom and not about
me, and comprehend that the quality and consistency of counselling takes precedence over my comfort and personal
preferences. It is with these things in mind that I make these commitments:
Spiritual Commitment
• I acknowledge the Lordship of Jesus Christ in my life and have a personal relationship with him
• I am committed toward growing and maturing my relationship with God through personal devotions, personal times of
worship, and accountability
• I am committed to taking time out every day to read my Bible and pray
• I will pray for my campers and other counsellors (as a group and as individuals) regularly
• I will be a team player, having a Christ-like attitude, choosing the good of the team over my own personal preferences
• I am prepared to lead devotions and spiritual discussions
• I will be ready at all times to discuss a relationship with Jesus Christ with any camper
• I am committed to praying for the campers and counsellors at Camp and my involvement in it
Lifestyle Commitment
•
•
•
•
•
•
I understand that as part of Kids Camp, I cannot let my life become inconsistent with the Word of God
I will maintain a positive attitude towards all aspects of ministry throughout Kids Camp
I will give full support and cooperation to the Camp Director and those in leadership
I will work with other counsellors to hold one another accountable in Christian behaviour and conduct
I will work to facilitate a safe and positive camp experience
I am committed to releasing back to God my time and energy as an act of worship, trust and obedience to God
Time Commitment
• I will, with a positive attitude, participate fully in everything and make sure our group is on time for all events and
services
• I will attend the Counsellor Training Session on July 5 at 12 noon and will attend all staff meetings
• Because I am making a significant commitment and my presence is important, I agree to be consistent and timely in
my responsibilities
Event Commitment
•
•
•
•
•
I will make every effort to be part of the team by giving all members my support
Everything I do in this ministry will be done to the best of my ability for the glory of God
I will do all I can to lead the kids into the presence of God through my ministry
I understand, agree, and will work hard to fulfil the purposes and vision of Kids Camp
I will serve as a friend and confidante to my campers. I will get to know as many campers as possible – not just the
one ones in my cabin
• I will not take pictures or video of the campers and post them to any social media site.
I will attend the Prep Meeting at 12 noon on July 5 at the camp and review the materials provided for me. o Yes o No If no, why not?
I have read and understand the above standards for my ministry commitment as a counsellor at Kids Camp.
Name (Please Print):
Signature: Date:
MLPC Kids Camp Counsellor
July 5-10, 2015
PO Box 445, Glendon, AB T0A 1P0
Email: [email protected], 780-635-2484
Information will be kept confidential.
Name of Applicant:
Dear Pastor:
This individual has applied to be a counsellor for Moose Lake Pentecostal Camp - Kids Camp. You would assist us greatly
by taking a moment to fill out our questionnaire. When completed, please do not return this questionnaire to the applicant,
but rather forward it to: PO Box 445, Glendon, AB T0A 1P0. THANK YOU!
1. I have known this applicant for years.
2. To my knowledge, the applicant is born again:
o yes
o no
3. Please select the following statement (this will not affect our decision as we accept both types of applicants).
o Camp will be good for this person
o This person will be good for the camp
4. The applicant is involved in ministry with children in the following ways:
5. The applicant readily submits to authority:
o readily
o usually
o reluctantly
o with difficulty
o not sure
6. The applicant works well without supervision:
o poorly
o fairly well
o needs direction o very well
o not sure
7. The applicant is able to counsel, and pray with others:
o seldom ministers to others
o finds it difficult
o not sure
o effectively
8. The applicant demonstrates effective time management and personal responsibility:
o strongly agree
o agree
o disagree
o not sure
9. Would you hire the applicant for a week-long camp ministry through your own church?
o yes
o no
10. Do you have any concerns about the applicant's commitment to children or the applicant's personal background which
would affect his/her ability to minister or which would place children at risk?
11. Additional comments:
Pastor's Signature:
Pastor's Name (Please Print):
Pastor's Email:
Date:Phone: