Fields marked with a * are required

(A prior accusation is not an automatic bar to participating in a Rainbow Trail Lutheran Camp sponsored program with your congregation.  The type of accusation and when it occurred will be evaluated by the camp before any decision is made.)

The above statements are true and complete to the best of my knowledge. Any falsification, misrepresentation, or incompleteness in this disclosure is alone grounds for disqualification or dismissal. The information that I have provided may be verified, if necessary by contacting persons or organizations named in this application.

I hereby waive any and all rights and claims that I might have regarding Rainbow Trail Lutheran Camp, it's employees, owners, officers, directors, and agents for seeking, gathering and using truthful and non-defamatory information in a lawful manner, in the employment process and all other persons entities or organizations for furnishing such information about me.

I also give permission for the use of photographs, video, and electronic images of me in camp materials and publicity.

By typing by name below I acknowledge that I personally completed this form truthfully and I agree that my typed name is the same as my valid legal written signature.

Any applicant who knowingly or willfully makes a false statement of any material fact or thing in this application is guilty of perjury in the second degree as defined in section 18-8-503, Colorado Revised Statues, and, upon conviction thereof shall be punished accordingly.