JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Returning Lifeguard Application
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Full name
*
Your answer
Preferred Name
*
Your answer
Sex
*
M
F
(If under 18) Birth Date
MM
/
DD
/
YYYY
Permanent Address
*
Your answer
Temporary/School Address
Your answer
Phone Number
*
Your answer
Availability
Please list the first and last dates you are available, and note any dates you are unable to work.
*
Your answer
Are you offering your services for:
*
Wages
Voluntary service
Please check the boxes to indicate when you generally ARE available to work.
*
Sunday Morning
Sunday Afternoon
Sunday Evening
Monday Morning
Monday Afternoon
Monday Evening
Tuesday Morning
Tuesday Afternoon
Tuesday Evening
Wednesday Morning
Wednesday Afternoon
Wednesday Evening
Thursday Morning
Thursday Afternoon
Thursday Evening
Friday Morning
Friday Afternoon
Friday Evening
Saturday Morning
Saturday Afternoon
Saturday Evening
Required
Positions Applying For
*
If you are applying for more than one position, please list them in order of preference.
Your answer
Education Update
*
Please include:
Name of College, Major, Anticipated graduation year, and Current class
(Fr., Soph., Jr., Sr., Graduated)
and/or
Name of High School and Current class (Fr., Soph., Jr., Sr., Graduated)
Your answer
Employment Update
*
Please list all employers since working here (paid or volunteer)
Format: Position, Employer/Organization, Supervisor, Phone, Dates Worked
Your answer
Spiritual Life and Additional Information
Please answer the questions below in sufficient detail.
1. Why are you interested in returning WCRC as a lifeguard?
*
Your answer
2. In what ways, if any, are you different or more mature than your previous summer?
*
Your answer
3. Write about some ways in which you had an impact on the lives of the pool patrons and other staff.
*
Your answer
4. What are some of the most significant things you learned while working here previously?
*
Your answer
5. What have you been doing to grow spiritually in the last several months? What is God doing in your life and teaching you recently?
*
Your answer
6. List your three top priorities/goals for your time this coming summer, if hired.
*
Your answer
7. Have you lifeguarded any since last summer? If so, where and how often?
*
Your answer
8. Is your lifeguard certification current? Is your first aid and CPR for professional rescuer current?
*
Your answer
9. Have you ever been convicted of a felony or misdemeanor, or pleaded no contest in a felony, other than a minor traffic violation? If yes, specify conviction, date, and location of conviction.
*
Your answer
10. Have you ever been accused or convicted of physically or sexually abusing anyone?
(If yes, please explain)
*
Your answer
11. Do you have any physical/emotional/health conditions that would make it dangerous or difficult to work the long and demanding weekly hours of a lifeguard schedule? (If yes, explain)
*
Your answer
12. Is there anything that would interfere with your ministry at WCRC such as behavior that is contrary to Christian values, substance use, or inappropriate language? (If yes, please explain)
*
Your answer
References
*
Your application is not complete with out references from three adults.
-The Pastoral Reference should be from your pastor or youth leader
-The Employer Reference from a former supervisor (employment, volunteer, or academic)
-The Personal Reference should be from another adult of your choice (non-related)
Do not use peers, immediate family members or current WCRC staff as references. Contact your references before listing. Complete the contact information in full. Email your references
this link
and ask that they
fill it out promptly. Thanks!
Please list your three references'
Relationship to you,
Name, Address, Position, Phone, and Email below.
Your answer
I certify that the information given on this application is true. I also give Williamsburg Christian Retreat Center permission to conduct a criminal history record request and a child abuse/neglect report. I understand that my employment may be contingent upon information contained within these reports.
I hereby give the Williamsburg Christian Retreat Center permission to exchange information with the references I have provided regarding my ability to serve as a summer staff person at WCRC.
Applicant's Electronic Signature
*
I agree and understand that by signing the Electronic Signature Acknowledgment and Consent Form, that all electronic signatures are the legal equivalent of my manual/handwritten signature.
Your answer
Date
*
MM
/
DD
/
YYYY
Parent's Electronic Signature (If applicant is under 18 years of age)
I agree and understand that by signing the Electronic Signature Acknowledgment and Consent Form, that all electronic signatures are the legal equivalent of my manual/handwritten signature.
Your answer
Date
MM
/
DD
/
YYYY
Send me a copy of my responses.
Submit
Page 1 of 1
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This form was created inside of Williamsburg Christian Retreat Association.
Does this form look suspicious?
Report
Forms
Help and feedback
Contact form owner
Help Forms improve
Report