Note: Meeting the deadline does NOT secure admittance to camp.

Minimum age requirement: Youth Camp - 20 years/Kids Camp - 18 years

Deadline to return applications for ALL YOUTH CAMPS IS March 27, 2025

Deadline to return applications for ALL KIDS CAMPS IS April 3, 2025

Please read the Camp Info sheet and keep for your records. Click Here to access it.

Required Acknowledgement

I hereby certify that I have read and agree to the information in the Camp Info Document.

I, the undersigned, agree to the terms above.

Select Camp(s) For Which You Are Applying

If you want to purchase a T-Shirt, select size Size (a $15 cost will be charged)

National Background Check

All background information must be submitted. If it is not included or the payment and request for it to be done is not marked, the form cannot be submitted. This may result in the applicant not getting a bed. The form below will prompt you to either include your documents or request we run the checks for a fee of $25.

Options for NBC:

I am providing a National Background check. (Completed no earlier than July 25, 2024)
UPLOAD BELOW
I am asking that that you run a National Background Check (a $25 fee will be charged to your church's invoice total)
Download Disclosure Regarding Background Check Investigation, MUST BE NOTARIZED.

This can be done after submitting this application. THIS MUST BE NOTARIZED, --> Authorization and Release 2025.pdf

You may complete and submit online at Summer Camps — Arkansas District

Competed NBC

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Child Maltreatment Central Registry (CMCR)

Options for CMCR:

I am providing a CMCR Letter check. (Completed no earlier than July 25, 2024)
Upload Below
I am asking that that you run a CMCR.

You may download CMCR Form, complete and submit online at Summer Camps — Arkansas District

This can be done after submitting this application. THIS MUST BE NOTARIZED, download--> CMCR 2025.pdf

Completed CMCR Letter

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Personal Info

Name

If Female, List Maiden Name

Mailing Address

Home Phone Number

Cell Phone Number

Date of Birth

Age

Biological Gender

Male
Female

Emergency Contact

Emergency Contact Phone

Additional Information

Church Name by city, choose "other" if not listed

If church is not listed:

How long have you attended your church?

Checkbox

Check here if less than 10 years

If less then 10 years, list name and location of other churches in which you were a member, or regularly attended during the past ten years.

Conversion Date

Date Received Holy Spirit, put "N/A" if still seeking

I have worked Arkansas District Camp(s) in the past.

List positions you have worked

Check here if you have medical training (i.e. RN, LPN, EMT, First Aid Certification).

Please explain your medical training

Please select a number by the duties you prefer in order of choice (#1 - #10)

1 being TOP pick and 10 being LEAST.

Team Leader

Basketball

Anywhere Needed (Seriously)

Softball/Kickball

Volleyball

Game Activities

Water Activities

Go-Karts

Concessions

Camp Store

Personal Information

Do you currently use tobacco, alcohol, or any illegal drugs

Have you ever been accused , charged, or convicted of a criminal offense, excluding traffic violations

If yes, you must explain:

Have you ever been accused, charged, or convicted of child abuse or a crime involving any sexual misconduct of/with a minor or any other person?

If yes, please explain

Medical and Insurance Information

Do you have any physical handicaps or conditions which limit your performance?

If yes, please explain

List any medications to which you are allergic. If none, indicate "none" or "n/a"

Name of Insurance Carrier. If none, indicate "none" or "n/a"

Insurance Co. Phone Number

Policy Number

Group Number

Subscriber's Name

Subscriber's Date of Birth

Name of Family Physician

Physician's Phone

Employer's Name/Address/Phone #

Upload a copy of your insurance card - front and back

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Certification

I hereby certify that all above information is true and accurate to the best of my knowledge

I, the undersigned, agree to the terms above.

Date Field

Required Terms

Applicant's Statement:

+The information contained in this application is correct to the best of my knowledge, information, and belief.

+I, the undersigned, hereby authorize the director or other responsible staff acting on behalf of the Arkansas District Council, to act as my Agent, to consent to medical, surgical or dental examination and/or treatment. In case of emergency, I hereby authorize treatment, and/or care at any hospital. If there is an emergency, please contact the above emergency contact.

+I acknowledge that participation in all camp-related activities necessarily involves risk of physical injury. I attest that I am physically capable to participate in this event. however, should directors, representatives or volunteers determine in their sole discretion that completion or participation in any games or events would be injurious to my health, or should I become ill or injured, I consent to my removal and treatment by any physician or medical care provider at the direction of the event director and/or assistant.

+I give my permission for free use of any videotape, photographs, audiotapes, or any other visual or audio reproduction in which I may appear by the Arkansas Assemblies of God. I release the Arkansas Assemblies of God from any liability connected with the use of picture or voice recording as part of any promotion.

+I understand that the Arkansas District Camps and the rented facility make rules and guidelines that I will abide by while attending camp. I agree to be given any position or assignment, be placed in any room, and if need be, go beyond the duties of the assigned position.

+In addition, I will pay for any damage I have done to the camp or to personal property belonging to another individual. I give permission to the camp director and/or assistant camp director to inspect the contents of any/all of my personal belongings, and to withhold and/or dispose of any improper or illegal contents.

+Should my application be accepted, I agree to be bound by the policies of the Arkansas Assemblies of God, including all camp rules, and to refrain from unscriptural conduct in the performance of my services on behalf of the camp.

I, the undersigned, agree to the terms above.

Date Field

Camp Training Video & Ministry Covenant and Agreement

You are REQUIRED to watch the Camp Training Video and accept the Covenant Agreement before your application is considered complete and attend camp.

The Camp Training Video and Covenant Agreement can be found on the ASM Camp page and the link below and can be completed after submitting this application.

-->Camp Training Video & Covenant — Arkansas District

Pastoral Recommendation

You are REQUIRED to have a completed Pastoral Recommendation before your application is considered complete and attend camp unless you are a credentialed minister or spouse of a credentialed minister.

Pastoral Recommendations can be completed online by visiting the ASM Camp page or using the link below and can be completed after submitting this application.

-->Pastoral Recommendation

I am a credentialed minister with ARAOG.