ADTC Hired Staff Form

Before you begin, please submit your Direct Deposit Form with bank info for weekly payments!
If your bank info is the same as last time you were on staff, you do not need to re-submit the direct deposit form.

2025 Hired Staff Form

The health & safety of our campers, families and staff is always our highest priority.
The risk for contagious illnesses (including lice, strep throat, flu, etc.) is always a consideration for camps where children & staff live together in close proximity, even in non-pandemic years. We rely on our staff to arrive healthy to camp, so please do your part! If you develop symptoms of illness in the 14 days leading up to camp (fever, throwing up, diarrhea, runny nose, coughing, sneezing, etc.), stay home and contact your Program Director. Even if you feel healthy, please do your best to reduce exposure to illness in the 14 days before arrival at camp.

Please complete and submit your Hired Staff Form (below) by 2 weeks before your first camp session.

Full disclosure is appreciated here! This form is where you'll upload contracts, give us your emergency contacts, insurance details, and health history. To submit this form, you'll need the following items ready for upload:

1. W-9 Form
2. Your signed offer letter (that we emailed to you)
3. A signed PD Contract if hired as Program Director
4. Vehicle Info Sheet + picture of car insurance if driving to camp
5. A picture of your health insurance card (front & back)
- * Note: If you don't have health insurance, we'll need a signed Insurance Waiver or proof of temporary insurance during camp dates! We also recommend temporary medical insurance (like Travmark or Insure My Trip) if your insurance doesn't cover illness/injury out of state.
6. Your Staff Health Exam Form (or your equivalent school/sports health form) signed by a licensed health professional and dated no earlier than 2 years prior to working at ADTC.
- * Note: if submitting the ADTC health form, it includes immunizations, otherwise please have a picture of your immunization records handy.
- 7. A picture of your First Aid & CPR Certification (need to renew? Please do it online here - $37)
8. A signed ADTC Staff Release
9. A signed Staff Code of Conduct

Please also read and be familiar with our Mission/Manifesto, Staff Training Manual , PD Manual (if hired as PD), & ADTC Policies.

If you don't have everything you need to submit this form today, you can still get started by filling out the info that you do have! Simply click "Save and Continue Later" (bottom of form) to receive a unique link you can use to finish filling out the rest of your form at your convenience.

"*" indicates required fields

This field is for validation purposes and should be left unchanged.

Your Name*

First Last

Middle Name (if you have one)

We need this for your background check.

Your Contact Email*

ADTC Location (please choose all that apply)*

Session Start Date*

Number of Weeks*

Birth Date*

Age (at time of camp)*

Staff Social Security Number

We need your Social Security Number for your 1099 tax form. You can also give this to us on your W-9 form.

Are You an ADTC Alumni?*

Check yes if you are either a camper or staff alumni (or both!)

Yes

Number of summers at ADTC (including 2024)*

Current Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Have You Lived at Another Address in Last 5 Years? Please list!*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Please Upload Your W-9 & Signed Offer Letter Here*

Multiple file uploads allowed - please upload all that apply:
1) W-9 Form)
2) Your Signed Offer Letter (emailed to you)
3) PD Contract (only if hired as Program Director)

Drop files here or

Max. file size: 50 MB.

Please Upload Your First Aid & CPR Certificates*

If you aren't certified or if you need to renew, here is a link to an online CPR/First Aid Training Class - it's just $37 w/ the Red Cross and takes about 2 hours to complete. All ADTC staff must have current CPR/First Aid Certification to work at camp.

Drop files here or

Max. file size: 50 MB.

Vehicle Info Sheet

Please upload your Vehicle Info Sheet if you plan to drive to camp

Drop files here or

Max. file size: 50 MB.

EMERGENCY CONTACT INFO

This information is gathered to assist us in identifying appropriate care. Update required annually.

Emergency Contact Name*

First Last

Relationship*

If other, what is relationship?*

Mobile Phone*

Email*

Emergency Contact #2*

First Last

Relationship*

If other, what is relationship?*

Mobile Phone*

Email*

INSURANCE INFO & RELEASE

All ADTC contractors must be covered by their own health insurance to work at camp. ADTC DOES NOT provide contract workers with medical insurance or worker's compensation. Please have a picture or scanned copy of your insurance card ready for upload below.

* Note: If you sustain an injury or get an illness at camp, you are required to pay for any out-of-pocket expenses and then submit the claim to your insurance company. Contractors are responsible for paying all physician's fees and prescription costs incurred while at camp. If you do not have medical insurance, or if you won't be covered out of state, please look into temporary medical insurance! We recommend Travmark or Insure My Trip.

Please upload a picture of your insurance card (front & back)*

If you are not insured, please upload a signed Insurance Waiver

Drop files here or

Max. file size: 50 MB.

Policy Holder's Name*

First Last

Social Security Number of Policy Holder*

Name of Insurance Company*

Phone Number of Insurance Company*

Policy Number*

Group/ID Number

Upload your Releases & Agreements

Please read & sign the ADTC Staff Release for upload here

Drop files here or

Max. file size: 50 MB.

HEALTH HISTORY

Full disclosure is appreciated here.

Upload your Staff Health Exam Form & Immunization Records

We'll accept either 1) the ADTC Staff Health Form, or 2) your equivalent form, as long as the form is signed by a licensed health professional and dated no earlier than 2 years prior to attending ADTC. If using the ADTC form, it will also include immunizations, otherwise please upload immunization records separately.

Drop files here or

Max. file size: 50 MB.

Are you fully immunized?*

Note: In addition to routine immunizations (Measles, Mumps, Rubella, Chicken Pox, Tetanus, Hepatitis B, Diphtheria, Pertussis, Pneumococcal Conjugate, Polio, etc.), we have a strong preference for all staff to meet the CDC requirement for up to date COVID vaccinations.

Please upload your Immunization Records*

We'll accept a picture or copy of your immunization forms from health-care providers or state or local government.

Drop files here or

Max. file size: 50 MB.

Do you have any dietary restrictions?*

Check all that apply*

Does not eat red meat

Does not eat poultry

Does not eat pork

Does not eat seafood

Does not eat eggs

Does not eat dairy products

Other

Details*

Do you have any known allergies to medications, food, insects, animals, etc.?*

Details*

Have you had any recent injury, illness or infectious disease?*

Details*

Do you have any chronic or recurring illness/condition?*

Details*

ADTC STAFF AGREEMENTS

Please review the agreements below before signing.

I have read the ADTC Manifesto, Staff Training Manual, MESH Resource Guide ("Mental Social Emotional Health"), PD Manual (if PD), policies regarding camp rules and expected behavior & policies regarding keeping in touch outside of camp.*

*Please bookmark these resources so you can refer back to them as needed during camp!

ADTC Manifesto
ADTC Staff Training Manual
PD Manual (only if PD)
ADTC Policies
MESH Resource Guide

I have read the material

Staff Code of Conduct Upload*

Please upload your signed Staff Code of Conduct here.

Drop files here or

Max. file size: 50 MB.

I understand I may have to administer an EpiPen at camp & I have watched the instructional video (link below).*

How to Use an EpiPen Video

I have watched the video

I understand how to administer an EpiPen

I understand and agree that my ADTC contract is at-will, which means I have the right to terminate my contract at any time and for any reason, and ADTC has the same right.*

I agree

I understand that my contract at ADTC is contingent upon the successful completion of a background check & pre-camp staff training. I further understand that my contract at ADTC is dependent on camper enrollment.*

I understand

I understand that in accepting a position at ADTC, I am agreeing to forego all other job leads or potentially conflicting activities, including performance opportunities. I further understand that, due to circumstances such as low enrollment or other factors, there is always a chance that ADTC may have to cancel a session I have been hired for.*

I understand

I agree to follow and help uphold each of ADTC's camp rules. I agree to listen to, respect and be responsible to other staff and the camp's Program Director.*

I agree

I agree to be the best possible "CEO" (meaning "Chief Experience Officer") while at camp. I will do my best to understand and employ the ADTC camp mission, manifesto, philosophy, objectives, and goals in my relationships with campers, parents & staff.*

I agree

I agree to conduct myself in an exemplary manner, recognizing that I am an adult role model for my campers. I agree to demonstrate high moral values and always be truthful and make appropriate choices. I also recognize that my behavior away from campus - including my behavior online - reflects on ADTC.*

I agree

I understand that by becoming an ADTC counselor, I am accepting one of the greatest responsibilities there is in life - to be entrusted with the health, well-being and education of young girls. I understand that my role is complex: I am a teacher, friend, disciplinarian, mentor, dance instructor and protector of each of my campers, sometimes all at once. I understand and accept this important responsibility.*

I understand

I agree to accept the diverse racial, national, religious, and cultural backgrounds of ADTC campers & staff, and not to impose my own particular views.*

I agree

I agree to respect the camp, the facility, all ADTC faculty and all campers. I understand that disrespect, rudeness and profanity are NOT tolerated. I understand that ADTC is a positive place and that teasing, making fun, discriminating, bullying or putting down anyone will not be accepted under any circumstance. If I need to have a sensitive or potentially difficult conversation with another staff member, I will wait for a good time and find a private location. I agree never to put down or dismiss a fellow ADTC staff member in front of campers.*

I agree

I understand that tobacco products, alcohol, drugs, or weapons are never allowed at ADTC.*

I understand

I agree to respect the property of campers and other staff and understand that stealing is never tolerated. I understand that I will be held responsible for any intentional property damage, including damage caused by reckless or irresponsible behavior, to ADTC property or to the property of campers or fellow staff. I agree never to move heavy furniture in dorm rooms, lobbies or dance spaces without express permission from the host facility.*

I agree

I understand that campers cannot have cell phones, computers or similar devices at camp, except for call home night. Therefore, I will not not make phone calls or text in front of campers. I will only use my phone when absolutely necessary in front of campers (to take pictures, contact other staff members as necessary, etc.)*

I understand

I understand that if I disobey the rules of our camp and/or negatively affect the experiences of campers or other staff, I will be sent home from camp immediately and my pay may be pro-rated.*

I understand

I understand that ADTC has a zero-tolerance policy for inappropriate behavior as defined above. I understand that if I am found to be breaking camp rules and my contract is terminated, I will need to make arrangements to leave immediately, and that my pay may be pro-rated.*

I understand

I understand that ADTC is taking reasonable measures to prevent the transmission of COVID-19 and other communicable diseases consistent with applicable public health guidelines. I also acknowledge and recognize that it is impossible to ensure that the camp and facilities are 100% free of COVID-19 and other communicable diseases, and that being at camp contains inherent risks that cannot be eliminated regardless of the care taken to avoid the spread of communicable disease. I acknowledge, understand, and appreciate these and other risks are inherent in participating in camp.*

I understand

Staff Digital Signature*

First Last

Today's Date*