LIT PAPER WORK CHECK LIST
*****Please Print all Paper Work Single Sided*****
NAME: ___________________________________________________
LIT Job Description
LIT Code of Conduct
Employee Indemnity
Assumption of Risk
Background Consent Form
Immunization Policy
DHS Maltreatment
Criminal Record
Personal Policy
Physical
Spiritual Philosophy
Staff Dress Code
Acknowlegdment of Summer Schedule
Time Off Request - If Needed
Copy of Shot Records
Copy of Medical Insurance Card
JOB DESCRIPTION & CONTRACT​ | L.I.T. Volunteer ​Student
I. PURPOSE OF THE JOB
● To provide Camp War Eagle with all necessary support functions including: event
set up, event clean up, and facility maintenance
● To gain experience working in a fun, fast-paced, mentally and physically
challenging work environment
● To gain experience working productively on a team
● To learn useful technical skills which can translate to other occupations
● To learn valuable life skills that are able to positively influence a broad range of
life events (college, employment, conflict resolution, budgeting, spiritual growth)
II. QUALIFICATIONS
● Must be a graduating High School senior (some exceptions for juniors- approved
by LIT director)
● Must have reliable transportation to and from camp
III. EXPERIENCE
Prior experience with Camp War Eagle is preferred but not required.
IV. RESPONSIBILITIES
Student responsibilities include, but are not limited to the following:
● Attend orientation and adhere to all safety principles
● Commit to working all required hours on an established ​schedule
● Communicate all preexisting vacation times
● Follow all supervisor instructions
V. ESSENTIAL FUNCTIONS
●
●
●
●
Able to lift a 50 pound box
Able to model Christ-like love to coworkers and supervisors
Able to perform necessary job functions in a timely manner
Able to operate equipment safely
VI. DURATION OF PROGRAM:​ June 4th, 2017- August 12th, 2017 (you are assigned 4
weeks during this time and those exact dates were included on the email you were sent with this
paperwork).
VII. COMPENSATION:​ There will be no compensation as this is a volunteer position.
VIII. SPECIAL TIME OFF:​ Any expected time off that the student will need this summer should
be outside of their assigned sessions as an LIT. Any time off outside of emergencies and
illnesses will not be permitted as their sessions should be scheduled in accordance to their
summer schedule. Emergencies and illnesses will be discussed on a case by case basis with the
LIT director. ​(CONTINUED ON BACK…)
I have read the above job description and essential functions and sign that I am capable
of functioning safely within the demands of this position.
______________________________________
Student Signature
__________________
Date
______________________________________
Parent Signature
__________________
Date
Camp War Eagle Code of
Conduct
This Code of Conduct should be read and understood by both the L.I.T. and his or her parent/s
or legal guardian/s (hereafter collectively “parent/s”) and signed by the L.I.T. and parent/s. If,
after reading this page, you have any questions regarding the Camp War Eagle Code of
Conduct, please don’t hesitate to contact the Camp War Eagle L.I.T. Coordinator.
Camp War Eagle strives to create a camp environment where all campers can have an enjoyable and
meaningful time. One of the ways in which we seek to achieve this goal is through the concept of
“Values-Based Camping.” Through this concept, Camp War Eagle strives to help our L.I.T.s
understand the mission of Camp War Eagle’s impact on campers in the following ways:
•
•
•
Develop a more positive self-esteem
•
Develop greater self-confidence
•
Interact with positive, Christian role models •
Become more independent
Learn the importance of friendship
Develop interpersonal relational skills
In order for the implementation of “Values-Based Camping” to be most effective, and to further an
enjoyable camp environment for all participants, Camp War Eagle has identified certain
expectations/rules, which all L.I.T.s must observe. We also think it is important that parent/s and L.I.T.s
be aware of these expectations/rules before arriving at Camp War Eagle. In addition, the expectations
and rules of camp will be reviewed with the L.I.T. at the beginning of each session. ​The L.I.T. and
parent should review these expectations/rules together, and then sign the statement that
follows.
1.
L.I.T.s are to respect other L.I.T.s, staff, campers, and their belongings. L.I.T.s must be
respectful in their expression through apparel, language, gestures, or writing. Inappropriate or offensive
language is not allowed.
2.
Bullying or abuse, in any form, is not allowed. Bullying and abuse can be both physical and
emotional.
3.
Use and/or possession of drugs or controlled substances (including improper use or
possession of any prescription or non-prescription drugs), alcohol, tobacco, knives of any type,
firearms (except in authorized camp activities) and other items deemed dangerous is strictly forbidden.
Violation may result in immediate expulsion from camp.
4.
L.I.T.s must keep prescription and non-prescription medicine at the health center. Special
circumstances must be cleared by the camp’s health center.
5.
Cell phones and other mobile communication devices (except in authorized camp
activities​) are strictly prohibited​. Other electronics, such as iPads, iPods, Apple watches, video
games, computers, etc., are also prohibited. Any such item brought to camp will be taken up and
returned on Closing Day. Camp War Eagle is not responsible for theft or damage to any L.I.T. personal
property.
6.
L.I.T.s will be expected to participate in all scheduled Camp War Eagle program activities
unless exempt because of health restriction.
7.
Inappropriate communication or physical contact with other L.I.T.s, campers or staff is not
allowed.
8.
L.I.T.s must follow Camp War Eagle rules and regulations at all times.
Camp War Eagle implements a system of participant monitoring in its effort to provide an incomparable
experience for all of its attendees. If Camp War Eagle determines that a L.I.T. is failing to adhere to the
Camp War Eagle Code of Conduct, or presents a safety, behavioral or other concern that is
detrimental to the L.I.T., other L.I.T.s, campers, staff or to the overall camp experience, Camp War
Eagle reserves the right to enforce consequences, in its sole discretion, designed to correct the
behavior or concern. Consequences may include, but are not limited to: limitation of privileges, verbal
and/or written warnings, parental notification, or, in extreme cases, expulsion from Camp War Eagle
without refund. Additionally, L.I.T.s who repeatedly fail to adhere to the Code of Conduct may run the
risk of not being allowed to attend Camp War Eagle as a L.I.T. or staff member in the future.
Once again, if you have questions regarding the Camp War Eagle Code of Conduct, please don’t
hesitate to contact the Camp War Eagle office.
By my signature below, I agree that I have reviewed the above Code of Conduct
expectations/rules and agree to its terms. If I have any questions regarding the Camp War Eagle
Code of Conduct, I will contact the Camp War Eagle L.I.T. coordinator. ​The L.I.T. and one of the
L.I.T.’s parents or legal guardians, or both, if available, must sign this Code of Conduct.
I agree the electronic signature affixed to this Code of Conduct is the legally binding equivalent of my
handwritten signature.
________________________________
L.I.T. Signature
__________
Date
__________________________________
Print Full Name Here
________________________________
Parent/Guardian Signature
__________
Date
__________________________________
Print Full Name Here
MEDICAL INSURANCE, MEDICAL RELEASE AND INDEMNITY AGREEMENT
CAMP WAR EAGLE- LIT
It is important to note that while students are participating in Camp War Eagle’s LIT program that they are NOT staff
members. This means that LIT’s are not eligible for worker’s compensation. LIT’s are a part of a volunteer training program.
They are NOT staff members or employees and therefore aren’t eligible for worker’s compensation. They are required to
carry their own health insurance and are responsible for 100% of any and all medical expenses incurred as a result of
participating in the program.
RELEASE AND INDEMNITY
I do hereby release, protect, indemnify and hold harmless Camp War Eagle Inc. and its agents, representatives, employees
successors and assignees, from and against any and all claims, liabilities, suits, actions or proceedings which may arise out
of, or in any way be connected with, any illness or injury during my time as a volunteer that is non-job related or occurs
during any and all time off periods or that occurs outside the "course and scope of my time as a volunteer." This indemnity
shall include, but shall not be limited to, indemnification with respect to any costs of defense and attorneys fees.
I understand and agree to the above conditions:
___________
Date
_______________________________
Student Signature​
______________________________________
​Printed Name
___________
Date
​
_______________________________
​ Parent Signature
​
______________________________________
​ Printed Name
CAMP WAR EAGLE L.I.T Volunteer:
ACKNOWLEDGMENT AND ASSUMPTION OF RISKS, ACTIVITIES PERMISSION
AND RELEASE AND INDEMNITY AGREEMENT
INTRODUCTION: ​Please read this entire Acknowledgment and Assumption of Risks, Activities
Permission and Release and Indemnity Agreement (hereafter, “Document”) carefully before
signing. ​The L.I.T. must sign this Document. The L.I.T.’s parent/s or legal guardian/s (hereafter
collectively “parent/s”) must also sign, whether the L.I.T. is an adult or minor ( minors are those under
18 yrs. of age; hereafter sometimes “minor” or “child”). (“We” refers to the L.I.T. and his/her parent/s).
In consideration of the services of War Eagle Interests, Inc., doing business as Camp War Eagle (also
referred to in this Document as “Camp War Eagle”) in allowing me/my L.I.T. to participate in Camp War
Eagle activities, ​we acknowledge and agree as follows:
ACTIVITIES, PERMISSION, RISKS AND ACKNOWLEDGMENT AND ASSUMPTION OF RISKS:
Camp War Eagle educational, instructional, adventure and/or recreational activities that I may
participate in and/or assist with (whether simply attending, observing or actively participating) include
risks. Activities, both indoors and outdoors, take place in Arkansas, either on or off the Camp War
Eagle leased premises and facilities (sometimes referred to in this Document as “Property”). Activities
can include but are not limited to: hiking; backpacking; rock climbing, bouldering (indoors or outdoors
on artificial surfaces or natural rock), and high ropes or challenge course activities (a series of cables
and structures of varying heights, some up to 250 feet, on and through which the L.I.T. will walk, swing
and otherwise travel), all of which can include belaying and rappelling and use of ropes, harnesses
and/or other technical gear; camping; horseback riding and horsemanship; mountain biking;
orienteering; fishing; skeet shooting, riflery and archery; swimming, water slides, blobbing, tubing and
other waterfront or waterpark activities; sailing; canoeing, kayaking, rafting and other boating;
waterskiing, wakeboarding, wakesurfing, riding the water shark or other watercraft use; hunter safety,
leadership and wilderness first aid skills and outdoor survival skills; athletic sports and games;
weightlifting and conditioning; skateboarding; cooking, baking, and grilling; camp crafts; woodworking;
socializing; service projects; camp chores; use of any equipment, facilities or premises; and travel or
transportation (for example) in cars, vans, buses and/or other vehicles, or by bike, boat, foot or by other
means (collectively referred to in this Document as “activities”). Activities (which may be provided or led
by Camp War Eagle staff, contractors or others) may be day or multi-day (including overnights),
scheduled or unscheduled, and include activities undertaken during L.I.T.’s free and/or independent
time. As identified above, I understand that the L.I.T. may participate in activities located off Camp War
Eagle Property. Some of the activities located off the Property can include, the L.I.T.’s lake day or
camping trip. ​I acknowledge that the inherent and other risks, hazards and dangers (collectively
referred to in this Document as “risks”) of these activities can cause injury (including mental or
emotional trauma, paralysis or other disability), damage, death or other loss to L.I.T. or others.
Activities Permission​: We agree we have or will review some or all of the Camp War Eagle website,
catalog, promotional videos, and other materials, which contain listings of most camp activities. L.I.T.
and parent/s ​give permission for myself/my L.I.T. to participate in all activities, including, as
identified above, permission to be transported in Camp War Eagle or contracted vehicles
(unless otherwise designated during the registration process). Parent/s agree to discuss the
nature of these activities and risks with their L.I.T. The following describes some, but not all of
these risks:
Risks associated with any outdoor or athletic activity. ​These risks include the risk that a L.I.T. may
overestimate his or her abilities or fitness; be inattentive; lose control and trip or fall and/or collide with
others, the ground, rocks or trees or encounter other water/terrain/road/trail hazards; not understand
the functioning of (or misuse) the equipment; fall or be bucked off of a horse or other equine; fail to
negotiate steep, uneven or difficult terrain; not control his or her speed or experience equipment
malfunction.
Equipment risks. ​The risk that equipment used in an activity may be misused, or may break, fail or
malfunction. This includes L.I.T.’s personal equipment, Camp War Eagle equipment or other equipment
(whether purchased, borrowed or rented). L.I.T.s choosing to bring and use their personal equipment
(including any safety gear) assume full responsibility, along with their parent/s, for choosing appropriate
equipment and for the fit and condition of their equipment. Helmets or other safety gear (required or
used for some activities) may prevent or lessen injuries in some instances; however, use of safety gear
is not a guarantee of safety, and injury can occur even with the use of this gear.
Risks involved in judgment and decision-making. ​These risks include the risk that the L.I.T., or a
staff member, contractor, co-L.I.T. or other person may misjudge the L.I.T.’s (or others’) capabilities,
health or physical condition, or misjudge some aspect of travel, instruction, medical treatment, weather,
terrain, water conditions or water level or route location.
Personal health and participation risks. ​The L.I.T.’s mental, physical or emotional condition,
disclosed or undisclosed, known or unknown, combined with participation in these activities includes
risks. Although Camp War Eagle representatives will review any submitted L.I.T. health information,
Camp War Eagle cannot anticipate or eliminate risks or complications posed by L.I.T.’s mental,
physical (including fitness level) or emotional condition.
Risks present in an outdoor environment. ​These risks include travel in hilly, outdoor terrain, both on
and off trail, and on land or water. L.I.T.s’ travel may be subject to storms, including rain, lightning, or
strong winds; extremely hot and humid weather or cold water; fast moving rivers or other water bodies,
including currents and waves; falling or slippery rocks; falling or fallen timber; stinging, venomous
and/or disease carrying animals, insects or microorganisms; poisonous plants; the unpredictable nature
of both wild and domestic animals and other natural or man-made hazards. Hazards (both on land and
above and below water level) may not be marked or visible and weather is always unpredictable.
Risks connected with geographic location. ​The camp’s rural location can cause potential delays or
difficulties in communication, transportation, evacuation and medical care. In addition, although staff or
contractors may have access to wireless communication devices (including cell/SAT phones), use of
these devices in outdoor or any other terrain can be unreliable and inconsistent.
Premises risks. ​Risks include slippery walkways, uneven ground, ruts, boulders, lakes, ponds, a high
ropes challenge course and other conditions existing in and around the Property.
Free time risks​. L.I.T.s will have free time. During free time, all L.I.T.s share in the responsibility for their
own well-being.
Risks regarding conduct. The potential that the L.I.T., or other L.I.T.s or third parties may act
carelessly or recklessly.
We further acknowledge and agree:
●
to accurately complete and sign all required forms, abide by the terms of those documents, and
obey all Camp War Eagle rules and other policies;
●
to review all Camp War Eagle information and materials received and pertinent information
available via Camp War Eagle’s website, and understand that Camp War Eagle representatives are
available should I have further questions about these activities or the associated risks;
●
to disclose any mental, physical or emotional condition/s or limitation/s which might affect the
L.I.T.'s ability to participate, and represent that the L.I.T. is fully capable of participating without causing
harm to him/herself or others;
●
the information provided above is not complete, other unknown or unanticipated activities,
inherent and other risks and outcomes may exist, and Camp War Eagle cannot assure the L.I.T.'s
safety or eliminate any of these risks;
●
if the L.I.T. is borrowing, renting or purchasing new or used equipment from Camp War
Eagle, the equipment comes "AS-IS," and Camp War Eagle disclaims all warranties, express or
implied (including any conditions of merchantability or fitness for a particular purpose) with
regard to the equipment;
●
Camp War Eagle contracts with organizations that are independent contractors (not their
employees or agents) to provide or conduct some of the services and activities L.I.T.s will engage in.
Camp War Eagle does not supervise or control these contractors and is not legally liable or responsible
for their conduct;
●
The L.I.T. is voluntarily participating with knowledge of the risks. Therefore, L.I.T., for
myself, and parent/s for myself and my participating L.I.T., assume and accept full responsibility
for the inherent and other risks (known and unknown, described above or otherwise) of these
activities, and for any injury, damage, death or other loss suffered by L.I.T. (and parent/s)
resulting from those risks, including the risk of the L.I.T.’s own negligence or other misconduct.
RELEASE & INDEMNITY AGREEMENT:
Please read carefully. This Release and Indemnity Agreement contains a surrender of certain
legal rights. I (L.I.T., for myself, and parent/s for myself and for and on behalf of my participating
L.I.T.), agree as follows:
1)
to release and agree not to sue Camp War Eagle Inc., SASGK, LLC doing business and
each of their respective owners, partners, officers, directors, employees, agents,
representatives, volunteers and all related or affiliated individuals or entities (hereafter
individually and collectively “Released Parties”) ​with respect to any and all claims, liabilities, suits
or expenses (including attorneys’ fees and costs) (hereafter “claim” or “claim/s”), for any injury,
damage, death or other loss in any way connected with my/my L.I.T.’s enrollment or participation in
these activities, including use of any equipment, facilities or premises. ​I understand I agree here to
waive all claim/s I or my L.I.T. may have against the Released Parties, bind my/my L.I.T.’s estate
and any family member/heir/other party bringing claim/s, and agree that neither I, my L.I.T. nor
anyone acting on my or my L.I.T.'s behalf, will make a claim against the Released Parties as a
result of any injury, damage, death or other loss suffered by me or my L.I.T.;
2)
to defend and indemnify ​(“indemnify” meaning protect by reimbursement or payment) ​the
Released Parties​, with respect to any and all claim/s brought by or on behalf of me, my participating
L.I.T., spouse or other family member/s, my/my L.I.T.’s heir/s or estate, another L.I.T. or any other
person for any injury, damage, death or other loss in any way connected with my/my L.I.T.’s enrollment
or participation in these activities, including use of any equipment, facilities or premises.
This Release and Indemnity Agreement includes claim/s of or resulting from the Released
Parties’ negligence, and includes claim/s for personal injury or wrongful death (including
claim/s related to emergency, medical, drug and/or health issues, response, assessment or
treatment), property damage, loss of consortium, breach of contract or any other claim.
OTHER PROVISIONS:
We agree that Arkansas substantive law (without regard to its "conflict of laws" rules) governs this
Document, any dispute L.I.T. or parent/s have with the Released Parties and all other aspects of each
of our relationship with the Released Parties, contractual or otherwise, and agree that any suit or other
legal proceeding must be filed and adjudicated only in Benton County Circuit Court, Benton County,
Arkansas. We agree to attempt to settle any dispute (not settled by discussion) through mediation in
Montgomery County, Arkansas before a mutually acceptable Arkansas mediator.
Image/Statement Authorization​: ​L.I.T. and parent/s of a L.I.T. authorize Camp War Eagle or parties it
designates the right and permission to photograph, film, record and/or otherwise capture the L.I.T.’s
name, image, voice, written statement, photograph and/or visual likeness (collectively “recordings”)
during camp and use those for display or otherwise on Camp’ War Eagle’s website, Facebook page or
other web based sites, or in marketing materials, CDs, DVDs, motion pictures or other form for any
informational, educational, promotional or other purpose, without compensation to the L.I.T. or parent/s.
We agree that Camp War Eagle shall own all ownership and copyright rights in the recordings. ​This
Document is intended to be interpreted and enforced to the fullest extent allowed by law. If any
portion of this Document is deemed unlawful or unenforceable, it shall not affect the
enforceability of other provisions, and the remaining provisions shall continue in full force and
effect.
L.I.T. and parent/s each agree: I have carefully read, understand and voluntarily sign this
Document and acknowledge that it shall be effective and legally binding upon me, my spouse,
my participating L.I.T. and other children, and parent/s and L.I.T.’s other family members, heirs,
executors, representatives, subrogees and estate. L.I.T. and one of the L.I.T.’s parents or legal
guardians, or both, if available, must sign this Document.
______________________________
L.I.T. Signature
____________
Date
_________________________
Print Full Name Here
______________________________
Parent/Guardian Signature
____________
Date
_________________________
Print Full Name Here
CAMP WAR EAGLE
BACKGROUND INVESTIGATION CONSENT AND RELEASE
I, ____________________________________________, hereby authorize Camp War Eagle and/or its
agents to make an independent investigation of my background, references, character, past employment,
education, credit history, criminal or police records, including those maintained by both public and private
organizations and all public records for the purpose of confirming the information contained on my
application and/or obtaining other information which may be material to my qualifications for employment
now and, if applicable, during the tenure of my employment with Camp War Eagle.
By signing below, I fully release Camp War Eagle and/ or its owners, agents, shareholders, representatives,
employees, successors and assigns, and related entities and any person or entity that provides information
pursuant to this authorization, from any and all liabilities, claims, or law suits directly or indirectly related to
any information obtained from or provided by any and all of the above referenced sources contacted or
used.
The following is my true and complete legal name and all information is true and correct to the best of my
knowledge:
Full Name – First, Middle, Last : _________________________________________________________
Maiden Name or Other Names Used: _____________________________________________________
Present Address: ___________________________________________ How Long?________________
City/State:_____________________________________ Zip Code:__________
Home Address(Parent’s): ______________________________________ How Long?________________
City/State:_____________________________________ Zip Code:__________
________________
Date of Birth
Signature
____________________
Social Security Number
_____________________
Driver’s License Number
________________
State of License
Date
NOTE: The above information is required for identification purposes only, and is in no manner used in
considering qualifications for employment.
PLEASE FILL THIS FORM OUT COMPLETELY BEFORE YOU SEND IT IN!
Camp War Eagle Immunization Policy
While Camp War Eagle respects every parent's decision to vaccinate or not, the vaccination of all
members of the camp community is essential in order to maintain a safe environment and decrease the
risk of transmission of preventable illnesses. The establishment and maintenance of a safe environment
must therefore include the requirement that all members of the camp community be adequately
immunized against all preventable diseases as recommended by the American Academy of Pediatrics
(AAP), Center for Disease Control (CDC), and the Arkansas Department of Health. The routine vaccination
of all children and staff is an important public health matter, especially in the confined environment of a
residential summer camp with round-the-clock communal living. No exceptions or exemptions will be
granted.
All staff and campers attending the Camp War Eagle residential and day camps are required to have had
all age-appropriate vaccines recommended by the American Academy of Pediatrics, Center for Disease
Control and Prevention and by the Arkansas Department of Health:









DtaP, DT, Td, or Tdap (Diphtheria, Tetanus and Pertusis)
Tdap vaccine
IPV (Poliovirus)
HIB (Haemophilus influenza type b bacteria)
Hepatitis B
Hepatitis A (This shot is recommended, but not required for summer staff unless you will be
serving in our Kitchen or are an international staff member)
MMR (Measles, Mumps, Rubella)
Varicella vaccine (Varivax)
Menactra (Meningococcal disease / Meningitis)
I understand that current immunizations are required to attend Camp War Eagle. I will notify camp if
I, the staff member, am exposed to communicable diseases during the THREE WEEKS PRIOR TO CAMP
ATTENDANCE (Chicken Pox, Measles, Mumps, Flu, etc.). *
I also will submit a current copy of my immunization record with all above immunizations.
____________________________________
Signed
___________________
Date
FACILITY/LICENSE# _____________________
ARKANSAS DEPARTMENT OF HUMAN SERVICES
DIVISION OF CHILD CARE & EARLY CHILDHOOD EDUCATION
Authorization for release of confidential information:
ARKANSAS CHILD MALTREATMENT CENTRAL REGISTRY
Note to users of this form:
Please type or print all information! Illegible forms will not be processed! Fill out
form completely. This form may be copied and shared.
RETURN THE ORIGINAL COMPLETED FORM TO: YOUR CHILD CARE LICENSING SPECIALIST
____________________________________________________
Camp War Eagle
____________________________________________________
FACILITY REQUESTING CHECK AND REPORT
NAME OF LICENSING SPECIALIST REQUESTING THE CHECK
____________________________________________________
922 Emma Ave
MAILING ADDRESS
____________________________________________________
TITLE
COUNTY
____________________________________________________
Springdale
72764
AR
CITY
STATE
ZIP
____________________________________________________
TELEPHONE NUMBER
____________________________________________________
FACILITY DIRECTOR & TELEPHONE NUMBER
TO BE COMPLETED BY THE PERSON TO BE CHECKED
____________________________________________________
DATE OF REQUEST
NAME OF PERSON TO BE CHECKED: _________________________________________________________________________
(MIDDLE NAME)
(LAST NAME)
(FIRST NAME)
MAIDEN NAME: ________________________________________________
DOB: (____________/____________/____________)
MONTH
DATE
YEAR
RACE: _______________
SEX: ( MALE/FEMALE )
ALIASES: ______________________________
SSN: __________-__________-__________
TELEPHONE NUMBER: (_______)_______________________
COMPLETE ADDRESS: ______________________________________________________________________________________
ZIP
STREET
CITY
STATE
PLACE OF EMPLOYEMENT: _________________________________________________________________________________
DOB
SOCIAL SECURITY NUMBER
FULL NAME/AGE OF OWN CHILDREN
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
"I hereby authorize the Arkansas Child Maltreatment Central Registry to release all information their files may contain including the
Prosecuting Attorney' s report, concerning the undersigned and any birth/legal children ages 10 through 17 who are now or have
resided in my home of the undersigned. I also understand that the name of any confidential informants, or other information which
does not pertain to me or my children, will not be released."
_____________________________________________________
DATE
SIGNATURE OF PERSON TO BE CHECKED
COUNTY OF ______________________________SS
STATE OF ARKANSAS
Acknowledge before me on this ____________________ day of ____________________
20 ____________________.
Notary Public ____________________________________________________
My Commission Expires: ____________________/____________________/____________________
DCC 316 R (2/04)
CONTINUED FROM THE FRONT SIDE:
LIST COMPLETE ADDRESSES YOU HAVE LIVED IN THE PAST SIX YEARS:
____________________________________________________________________________________________________________
ZIP
STREET ADDRESS
CITY
STATE
____________________________________________________________________________________________________________
ZIP
STREET ADDRESS
CITY
STATE
____________________________________________________________________________________________________________
ZIP
STREET ADDRESS
CITY
STATE
____________________________________________________________________________________________________________
ZIP
STREET ADDRESS
CITY
STATE
____________________________________________________________________________________________________________
ZIP
STREET ADDRESS
CITY
STATE
____________________________________________________________________________________________________________
ZIP
STREET ADDRESS
CITY
STATE
Arkansas Department of Human Services
Division of Children and Family Services
CERTIFICATION OF ABSENCE OF CRIMINAL RECORD
(For Youth Age 10-17)
Parent/Guardian Name:
Parent/Guardian Name:
Child’s Name:
DOB:
Child’s Name:
DOB:
Child’s Name:
DOB:
Child’s Name:
DOB:
Child’s Name:
DOB:
Child’s Name:
DOB:
I hereby verify that my child(ren) age 10-17 listed above do(es) not possess a criminal record.
Parent/Guardian Signature
Date
Parent/Guardian Signature
Date
County of
State of Arkansas
Acknowledged before me, this
day of
,
________________________________
Notary Public
CFS-341 ( R. 01/2014)
My commission expires:
CAMP WAR EAGLE POLICIES
The Camp War Eagle Summer staff member or volunteer is the primary instrument through which the objectives, goals, and
philosophy of CAMP WAR EAGLE are transmitted to the camper. The summer staff or volunteer is expected to be aware of the
following personnel policies:
1.
Camper Welfare: ​The first responsibility of each and every staff member or volunteer is the health and welfare of the
campers. Each staff member or volunteer is expected to show concern for and take a proactive approach to camper safety.
Physical punishment or any sexual contact between staff and campers is inappropriate and will be grounds for dismissal. A
non-medical staff member or volunteer shall not be alone with a camper or group of campers, outside the view of other
staff member or volunteers, unless there is an emergency or unavoidable circumstance. This is for the protection of the
camper and the staff member or volunteer, as well as the camp.
2.
Facilities:​ All staff and volunteers are responsible for care of the camp’s buildings and equipment. Camp vehicles and camp
animals are not available for personal use. Unauthorized use of camp gasoline, tools equipment, or supplies is prohibited.
Designated telephones and computers are available for personal calls and emails and are to be used only during designated
lunch or evening time-off. Office phones are for Camp War Eagle business only.
3.
Insurance: ​It is important to note that while students are participating in Camp War Eagle’s LIT program that they are NOT
staff members. This means that LIT’s are not eligible for worker’s compensation. LIT’s are a part of a volunteer training
program. They are NOT staff members or employees and therefore aren’t eligible for worker’s compensation. They are
required to carry their own health insurance and are responsible for 100% of any and all medical expenses incurred as a
result of participating in the program.
4.
Time-Off: ​Time-off periods are scheduled into the camp day based on your specific area of responsibilities at camp. Each
summer staff member or volunteer is granted time off during the two week term, unless a staff member or volunteer
becomes sick or there is another unavoidable circumstance with the staff member or volunteer or the camp.
5.
Alcohol/Tobacco/Controlled Substances: ​Alcohol and controlled substances are not allowed on the camp property. In
addition, employees are to refrain from the use of alcohol, tobacco and controlled substances during the entire term of
their employment with Camp War Eagle. Breaking this policy is grounds for immediate dismissal. Smoking and smokeless
tobacco are also not allowed on camp property.
6.
Internet Policies: ​Camp War Eagle views social networking sites (e.g., Facebook, Snapchat, YouTube, Twitter, Instagram,
etc.), personal Web sites, and Weblogs positively and respects the right of staff members or volunteers to use them as a
medium of self-expression. If a staff member or volunteer chooses to identify himself or herself as a staff member or
employee of Camp War Eagle on these sites, some readers may view the staff member or employee as a representative of
Camp War Eagle. As a condition of working or serving, Camp War Eagle requires that staff members or volunteers observe
the following guidelines when referring to Camp War Eagle, its programs or activities, its campers, and/or other staff
members or volunteers on these Internet sites.
a.
Employees or volunteers shall not make false statements in all communications and blogs related to or referencing Camp
War Eagle, its campers, and/or other employees.
Employees or volunteers must not use obscenities, profanity, or vulgar language.
Employees or volunteers shall not use these sites to make false statements about Camp War Eagle, campers, or other
employees or volunteers of Camp War Eagle.
Employees or volunteers must not use these sites to harass, bully, or intimidate other employees, volunteers, or campers.
Behaviors that constitute harassment and bullying include, but are not limited to, comments that are derogatory with
respect to race, religion, gender, sexual orientation, color, or disability; sexually suggestive, humiliating, or demeaning
comments; and threats to stalk, haze, or physically injure another employee, volunteer, or camper.
Employees or volunteers must not use these sites to discuss engaging in conduct that is prohibited by Camp War Eagle
policies, including, but not limited to, the use of alcohol and drugs, sexual behavior, sexual harassment, and bullying.
Employees or volunteers must not post inappropriate pictures of campers or staff member or volunteers. This category
includes but is not limited to pictures of staff members or volunteers participating in activities that violate Camp War Eagle
policy (e.g., alcohol, drugs, and/or sexual behavior), and pictures of campers who are not clothed or partially clothed.
Camp War Eagle does not host or sponsor a social networking site. The use of our copyrighted camp name or logo is not
allowed on behalf of the organization and/or for commercial purposes without written permission.
b.
c.
d.
e.
f.
g.
Social networking activities shall NOT be performed or engaged in while working, whether using employer provided facilities or
your own device. In sum, employees or volunteers should be working while at work. Employees or volunteers who use camp’s
computers to access such sites or engage in social networking are reminded, per other applicable policy, such access is not private
and information may be accessed or reviewed by the camp as the owner of the computer hardware and network. If you do use
employer provided computers or networks for personal use, be aware that the employer reserves the right to monitor, intercept
and review, without further notice, information stored or transmitted using our IT resources and communications systems. Your
use of these systems constitutes your consent to such monitoring.
If you chose to share personal, political, religious or other views or information in an on-line forum on your own time and using
your own device, you should a) do it in such a way that your audience would not conclude you are speaking for the camp; b) make
sure to be honest and accurate; c) never post any information or rumors that you know to be false about the camp, campers,
and/or fellow employees or volunteers working on behalf of the camp; d) recognize you are responsible for your own conduct and
obey all laws, such as Copyright laws; and e) use good judgment. If you have an employment related concern, you are encouraged
to follow our open door policy. Any employee found to be in violation of any portion of this Social Networking and Blogging Policy
will be subject to immediate disciplinary action, up to and including termination of employment.
7.
Community Relations: ​Staff and volunteers are asked to be sensitive to the people in the communities near Camp War
Eagle. Each staff member or volunteer represents the camp in his or her dealings with members of the local communities,
as well as in their behavior off of the camp grounds.
8.
Tips/Gratuities: ​Staff member or volunteers are asked not to accept any tips or gratuities from the parents or relatives of
campers.
9.
Health Services: ​A camp doctor and a staff of registered nurses are on duty at camp during the camp sessions and all staff
member or volunteers have access to their services as needed. While volunteering at Camp War Eagle as an LIT you must
carry your own insurance as Camp War Eagle does not cover or provide insurance to volunteers.
10. Sexual Harassment: ​Staff member or volunteers cannot use their positions of authority to take advantage of members of
the opposite sex. Any employee or staff member who has a question regarding any harassment shall bring it to the
attention of their immediate supervisor. Any individual who is found to have harassed another individual will be subject to
discipline.
11. Issues, Questions, & Grievances: ​Should there be an issue, question, or grievance over the interpretation of the Camp War
Eagle contract or policies or an issue, question, or grievance related to one’s duties, time off or relationships with fellow
staff member or volunteers, it should be reported to the human resources director or one’s supervisor immediately. Should
the human resources director or supervisor be the source of the issue, question, or grievance, the staff member or
volunteer may report the grievance to another supervisor or directly to the camp director. ​Staff member or volunteers are
legal adults, and therefore the Camp will only deal directly with the staff member or volunteer and will not address any
grievance, question, complaint, or correspondence via any staff person’s family members absent a health or welfare
emergency
12. Evaluation: ​In an effort to help the staff member or volunteer perform his or her duties at an optimum level, each staff
member or volunteer is evaluated. The staff member or volunteer’s supervisor will indicate the frequency of the
supervisory conferences, and at the conclusion of such conference, upon request, share a written evaluation with the
employee or volunteer. The evaluation information is kept on file with Camp War Eagle. One does not have to wait for a
scheduled supervisory conference to seek advice or Counsel from one’s supervisor. One of the primary responsibilities of a
supervisor is to be able to deal with the day to day problems of his or her assigned summer staff member or volunteers.
13. Termination:​ All employment contracts with Camp War Eagle are designated as “at will” contracts, which means they may
be terminated at any time by either Camp War Eagle or the employee.
14. Equal Opportunity Employer: ​Camp War Eagle is an equal opportunity employer. We provide opportunities to employees
and applicants without regard to race, color, sex, national origin, age, disability or veteran status. Part of the camp
experience is that the staff are held out as Christian role models and examples for the campers. Therefore, it is an essential
job requirement of every staff position that the staff member or volunteer be a practicing Christian in order to meet the
camps’ objective of providing Christian role models to the campers. Camp promotes and teaches principles of the Christian
faith to its campers, and this is part of the camp experience that the campers and their families expect.
ACKNOWLEDGEMENT OF CAMP WAR EAGLE PERSONNEL POLICIES
I acknowledge receipt of the Camp War Eagle Personnel Policies and understand that this document combined with my Contract
supersedes all prior documents and any other verbal or written agreements. I have read and understand the camp policies.
I shall endeavor to understand and faithfully interpret the camp philosophy, objectives, and goals in my relationship with campers
and all staff.
I shall conduct myself in an exemplary manner, recognizing that I am an adult role model for my campers. By my behavior, I will
always try to demonstrate high moral values. I recognize that my conduct when I am away from the camp premises also reflects on
Camp War Eagle.
I shall always seek to be truthful, honest, adaptable and fair in my communication and interaction with campers and all staff
including directors.
I accept the challenge of helping campers increase their awareness of and responsibility to others and to the world of nature,
helping them gain self-confidence and self-concept, and of teaching them new skills.
I have read and understand the Camp War Eagle abuse policies , code of conduct, and outside contact policies/guidelines. I will take
a proactive approach to camper safety (emotional, mental, and physical). I shall refrain from any type of abuse, abusive language
and any form of corporal punishment or embarrassment in my dealing with campers and other staff.
I shall be accepting of the diverse racial, national, religious, and cultural background of my campers, and not seek to unnecessarily
impose my own particular views.
Student Signature _______________________________ Date______________________
Printed Signature__________________________________Date______________________
Parent Signature ____________________________Date______________________
PLEASE RETURN THIS FORM
VOLUNTEER/PARTICIPANT NAME: ___________________________________________________________
BY APRIL 11, 2017
Last
First
PHYSICAL EXAMINATION – TO BE FILLED OUT BY LICENSED PHYSICIAN (Use the back of the form if necessary)
A physical examination of the volunteer/participant should be performed within twenty-four months before arrival at Camp War Eagle.
Examination is for determining fitness to engage in camp activities and responsibilities. (See description of camp environment &
activities below.) If the volunteer/participant received a physical examination last summer for being a camper at Camp War Eagle and it
was performed by a physician (MD, DO, APRN) on the Camp War Eagle physical form AND if the volunteer/participant has not had any
changes to his/her medical condition, then the volunteer/participant may provide a signed and dated copy of that physical to Camp War
Eagle (or it can be pulled from their camper record by request) in lieu of receiving another physical examination. All physicals must be
submitted on this official Camp War Eagle physical form unless we are using their camper physical from last summer (which should
already be on a Camp War Eagle physical form).
CODE:
 - Satisfactory
X – Not Satisfactory (explain)
O – Not Examined
Height ______ Weight ______ Ears
______ Heart ______ Blood Pressure ______ Extremities
______
Eyes
______ Throat ______ Nose
______ Lungs ______ Posture (spine) ______ Hemoglobin (optional)
______
Glasses ______ Dental ______ Skin
______ Hernia ______ Abdomen
______ Urinalysis (optional)
______
General Appraisal of ability to perform duties: ______________________________________________________________________
Allergy (ies): ____________________________________________________________________________________________________
Diabetes, arthritis, cancer or other illness or medical conditions: __________________________________________________________
Cognitive, mental, or emotional conditions: __________________________________________________________________________
Recommendations and restrictions while at Camp War Eagle: ___________________________________________________________
Swimming, Diving
_________________________
Strenuous Activity
__________________________
Dietary Restrictions
_____________________________________________________________________________
(Please notify Camp War Eagle in writing, in advance, of any major dietary restrictions, which require special menu adjustments. Camp War Eagle is unable to guarantee
that all requests can be met. Each case is considered on an individual bases.)
Other__________________________________________________________________________________________________________
Please list any medications the staff member will be taking at camp.
Prescription Name
Dosage
Frequency
1.
____________________ ___________________ ____________
2.
____________________ ___________________ ____________
3.
____________________ ___________________ ____________
Reason for Taking
_____________________________________
_____________________________________
_____________________________________
Note: If you have listed any medications in the above space, you must refer to and complete the medication portion
of the Medical History Section of the staff member’s My CWE Staff Dashboard.
Important Functions/Activities of Camp War Eagle Volunteer/Program Participant
The Camp War Eagle program is very active and physically challenging for staff members. A successful participant must be able to function physically,
mentally, and emotionally in a remote, rustic (non air-conditioned) atmosphere for a five to twelve week time period, depending on contract. The
participant may be involved in supervision of multiple young people under 18, strenuous physical activity, and extended work hours.
The participant must be able to safely perform the following daily activities with or without reasonable accommodation, which include but are not
limited to:

At least one hour every day of rigorous team competition and two to three hours of individual instruction, some of which are full-contact
sports that require physical stamina and most of which are conducted outdoors;

Travel across rough terrain, and strenuous physical activity;

Swim safely in a lake with limited visibility;

Supervision and interaction with multiple groups of young camp participants under 18;

Run, jump, pivot, cut, throw and hike with limited access to food and medical support at times.
If a chronic medical, emotional, or behavioral condition exists, the participant must be capable of performing the functions/activities listed above with
or without reasonable accommodation and should be capable of “self-management” of his or her condition due to the remote location of the camp
and limited access to medical care. If surgery has been performed for orthopedic repairs, the participant must use supports (braces, knee sleeves, etc.)
during all physical activities as directed by physician. A release from the physician must be sent to camp if the device is not necessary.
I have examined this person herein described and have reviewed his/her health history and the functions/activities performed at
Camp War Eagle described above. It is in my opinion that he/she is physically able to engage in camp activities and physical
demands of this position except as noted above.
Examining Physician Signature ________________________________ Date ______________ Phone ______________________
Print Name of Physician
________________________________ Email ___________________________________________
RETURN THIS HEALTH FORM AND COPY OF INSURANCE CARDS AND SHOT RECORDS TO THE CAMP WAR EAGLE OFFICES AT THE JONES
CENTER IN SPRINGDALE, AR. ADDRESS INCLUDED IN COVER LETTER OF LIT/LEAD DOCUMENTS RECEIVED.
Camp War Eagle Spiritual Philosophy
Camp War Eagle is a Christian camp and believes unequivocally in the truth of the Bible and in humankind’s
reconciliation to God as possible only through the death and resurrection of Jesus Christ. We believe that
salvation is available to everyone and is by God’s grace, through our faith and because of God’s love for us. We
believe that God desires for each of us to know and have a relationship with Him through His Son, Jesus Christ.
Camp War Eagle’s primary purpose and reason for existence is to share God’s love and His message of salvation
with all who come through its gates. With that as our basis, Camp War Eagle holds itself out to families as
providing a place where principles of Christian faith are taught, but more importantly, exemplified in the staff to
their children.
With this as our basis, we believe our greatest ministry happens in the relationships that are built between the
War Eagle Staff and War Eagle campers. We believe kids need to see and experience the love of God, a love that
many of them may not experience at home. Kids need to know that God loves them just as they are and we want
them to not only hear about God’s love, but to see that love in the lives of the War Eagle Staff. Because War
Eagle’s teachings and demonstration of Christian faith rely on the faith and conduct of the staff, it is therefore
imperative that each staff member share that faith in both word and deed.
We have two times during every camp day that are specifically geared toward sharing spiritual truths with the
kids. The first time is an evening chapel service, which is divided by age groups and is designed to be fun while
teaching kids about God’s love and His plan of salvation. We do not publicly invite anyone to put their faith in
Christ at any of these services. We do not want to force or pressure anyone to believe anything; but, rather, we
are looking for genuine and true commitments to Jesus Christ, which are always the work of God’s Holy Spirit.
The second, and most important time of the day is each cabin’s nightly devotional. This is a time of Christian
sharing between counselors and campers and is designed by age group. While these two times are of utmost
importance, they are most effective when accompanied by the counselor’s genuine desire to interact with, have
fun with, relate to, care for and love the kids. Remember, it is not the counselor’s specific job to ensure the
salvation of every child. It is his or her specific responsibility to make sure every child sees the love of God in his
or her life and allow the Holy Spirit to work in the soul of each child in His perfect timing.
While the focus of Camp War Eagle’s ministry is the kids, it is our hope and prayer that each Camp War Eagle
Staff member will grow in his/her relationship with God through the experiences that Camp War Eagle brings.
We do have opportunities each session for staff members to attend a Bible Study or a praise and worship time;
however, these times are limited. We believe and know that War Eagle Staff members primarily grow in their
relationship with God not through these times of receiving, but as they give themselves to the kids. For our staff,
Camp War Eagle is a place to know God’s love by putting it into action. It is a place to learn not by hearing, but by
doing. War Eagle Staff members will grow in their relationship with God as they focus on sharing God’s love by
putting it into action.
Above all, we recognize God’s supremacy and that it is only by His hand that our efforts are translated into an
effective and influential ministry in the lives of both War Eagle campers and the War Eagle Staff. I have read and
understand the above philosophy. In addition, I agree to work within the framework of this philosophy during my
employment at Camp War Eagle.
___________________________________
Employee Signature
_________________________________________
Date
STAFF DRESS CODE
Camp is just around the corner, and we are fired up for your arrival at Amazing Camp War Eagle!
Hopefully you are doing your best to prepare yourselves for the work you will do this summer
with our kids. We would like to help you do this by explaining the physical appearance standards
we hold for our Staff and volunteers. We are very conservative in the way we act and dress
because of the impression that it makes on the parents and the kids.
We would expect you to arrive to your first day at our residential camp or day camp adhering to
the following dress code standards that we hold for our Staff and volunteers. We do not think
any of these things below are necessarily bad in and of themselves; we just want our parents to
feel comfortable, on a first impression, leaving their kids with us for one or two weeks. If you
have any questions about any of this please call Chelsea Ariola at 479-751-8899.
GUYS
● No facial hair
● No long hair (above the ears and off the neck) If you can wear any part of your hair in a
“man bun”, it will be too long for purposes of your job at Camp War Eagle.
● No piercings of any kind
GIRLS
● No tight or revealing clothing, including swimsuits and special event clothing (i.e. ​no
two-piece swimsuits or halter top swimsuits​, tube tops, mid-drift baring shirts, extra
short shorts, extra-large tank tops, etc. )
● Tank tops are allowed but they must fit modestly. Armholes of tank tops should not
show skin below your sports bra.
● Visible piercings (except for ears and/or ​a ​VERY small nose stud) are not allowed. (Nose
rings not allowed)
EVERYONE
● No unnatural or bleached hair colors (meaning green, pink, blue, etc.)
● We expect you to dress modestly, keeping in mind that you are a role model for young
impressionable kids.
● We prefer our staff not to have large tattoos. However, if you have large ones, you will
be asked to keep them covered while you are at camp. Small, ​appropriate ​tattoos will
be allowed on a case by case basis.
● No clothing that exhibits or alludes to alcohol, tobacco, profanity, offensive symbols, or
sex is allowed at Camp War Eagle. (Sometimes Greek party shirts mimic some of the
items above in fun, but are still inappropriate.)
___________________________
Student Signature
__________
Date
___________________________
Parent/Guardian Signature
__________
Date
I have read over my summer schedule that was included in the email I received and I
understand the expectation of where/when I am assigned and agree with the placement. I
understand that during my time at Camp War Eagle I am a volunteer.
__________________________________
Student Signature
__________________
Date
__________________________________
Parent Signature
__________________
Date
SPECIAL TIME OFF REQUEST
THIS IS A REQUEST, NOT A GUARANTEE
Any time off exceeding 2 days should have been discussed prior with the LIT director when
scheduling sessions. This form is meant for time off requests that are 2 days or less such as
college orientation, family reunions, etc.”
NAME: _________________________________________
TODAYS DATE: ___________________________________
REASON FOR REQUEST: ____________________________
REQUESTED DATE(S): ______________________________
TOTAL DAYS REQUESTED: __________________________
APPROVED BY: _________________________________________________
APPROVED DATE: _______________________________________________