Adult Application Please fill out the Adult Application in its entirety. It has multiple pages and requires signatures. Step 1 of 3 - Contact Info 33% May 31 - June 4, 2026 Grace United Methodist Church Registrant Contact DetailsName(Required) First Last Email(Required) Cell(Required)Address(Required) Street Address City State / Province / Region ZIP / Postal Code Birthday(Required) Gender(Required)MaleFemaleOccupation(Required)T-Shirt Size(Required)SmallMediumLargeX-Large2X-Large3X-LargeChurch Membership(Required)Spouse's Name(Required)How many years have you participated in Sea City Work Camp?I am skilled in the following areas(Required) Painting Roofing Siding Woodwork Volunteers with no previous experience are welcome!Preference area to volunteer during camp(Required) Painting Roofing Carpentry Note: All work will be at the discretion of the Camp Director.Availability(Required) Sunday Monday Tuesday Wednesday Thursday Friday All Week Check all appropriate days PermissionsI can stay overnight as an adult chaperone(Required) YES NO I can drive a van to transport campers during the day.(Required) YES NO Must be at least 25 years of age AND provide a copy of your current Insurance Card.I can drive a van to transport campers during the evening.(Required) YES NO Must be at least 25 years of age to drive a SCWC vehicle.I have completed AND completed all required fields on the online application. I understand that my application will not be accepted until all paperwork is complete and that the cutoff date of April 26, 2025, is going to determine the number of worksites & campers that Sea City Work Camp will be able to commit to for the summer of 2025.(Required) YES NO RELEASE PHONE NUMBER FOR CAMP ROSTER(Required) YES NO RELEASE ADDRESS FOR CAMP ROSTER (INCLUDES E-MAIL ADDRESS)(Required) YES NO RELEASE ANY PHOTOS TAKEN DURING CAMP FOR FUTURE PUBLICITY, GRANT REPORTS, SOCIAL MEDIA(Required) YES NO Release of LiabilityI understand that the Sea City Work Camp, a housing rehabilitation project, is physically demanding. I recognize the risk of injury by participating in this event. I understand that I must assume the risk of injury and any related financial responsibility that could result from participating in these activities. I release the Corpus Christi District Office of the United Methodist Church, Sea City Work Camp, the participating churches, staff members, directors, and volunteers from all liability for any injury occurring while participating in any activities held during the Sea City Work Camp. I have read and agree to abide by the Sea City Work Camp Covenant as stated. I have read and understand this Release of Liability. I have completed this application with full honesty and I am liable to provide any information to the Camp Director in writing if there should be any changes to the camper’s application by the time camp begins.Participant Signature(Required)Your NameYour NameYour NameYour Name Medical Information1. Is there evidence or history of Heart Problems or High Blood Pressure chronic infection of nose, throat, ears, sinus, and lungs? If so, what?(Required)2. Have you had an appendectomy?(Required)3. Has there been recent exposure to a contagious disease? If so, what?(Required)5. Are you subject to: High blood pressure Fainting Convulsions Sleep walking Asthma Hay fever Overheating 6. List inoculations that are still active Tetanus Polio Others Date of Last Tetanus(Required) List other noculations that are active7. List all allergies Penicillin Sulfa Insect stings Drugs List other allergiesAny food allergies (list)?8. Are you on routine medication?(Required) Yes No If yes, name drug, dosage, and instructions9. List any diet restrictions10. Are there any restrictions or special needs be observed during work camp? (If so, explain)11. Family Physician(Required)Office Phone(Required)Insurance Company(Required)Insurance Policy Number(Required)Insurance in the name of(Required)Relationship to volunteer(Required)Helpful CommentsEmergency ContactName(Required)Relationship(Required)Phone (work)(Required)Phone (cell)(Required)Phone (home)In the judgment of any representative of the Sea City Work Camp, if I, the above-named participant, should need immediate care and treatment as a result of any injury or sickness, I do hereby request, authorize, and consent to such care and treatment as may be given to me by any physician, hospital, or Sea City Work Camp representative.Signature(Required)Your NameYour NameYour NameYour Name
