ADTC Hired Staff Form

Please complete this form at least 2 weeks before your first session. It takes approximately 15-20 minutes to complete.
You’ll be asked to upload documents and provide health + emergency information.

Please answer all questions honestly so we can best support you during camp. You'll need to have the following items ready:

Documents

• W-9 Form
• Signed Offer Letter
• PD Contract (if applicable)

Health & Safety

• Health Insurance Card (photo of 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.
• Your Staff Health Exam Form (or your equivalent school/sports health form)
- * Note: if submitting the ADTC health form, it includes immunizations, otherwise please have a picture of your immunization records handy.
- • A picture of your First Aid & CPR Certification (need to renew? Please do it online here)

Required Agreements

• A signed ADTC Staff Release
• A signed Staff Code of Conduct

If Applicable

• Vehicle Info Sheet + picture of car insurance if driving to camp

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.

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.

"*" indicates required fields

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BASIC INFO

Your Name*

First Last

Middle Name (if you have one)

We need this for your background check.

Email*

Phone Number

Birth Date*

Age (at time of camp)*

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

CAMP DETAILS

ADTC Location (please choose all that apply)*

California

Colorado

Illinois

Maryland

New Jersey

North Carolina

Texas

Vermont

Wisconsin

Session Start Date*

Number of Weeks*

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 2026)*

DOCUMENTS TO UPLOAD

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

All ADTC staff must have current CPR/First Aid Certification to work at camp. If you aren't certified or if you need to renew, online certifications are generally accepted. An in-person skills session may be required at certain ADTC locations, so the online + skills check course is recommended for flexibility.

Drop files here or

Max. file size: 50 MB.

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

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.

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

Drop files here or

Max. file size: 50 MB.

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.

Staff Code of Conduct Upload*

Please upload your signed Staff Code of Conduct here.

Drop files here or

Max. file size: 50 MB.

Upload your Releases & Agreements

Please read & sign the ADTC Staff Release for upload here

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 CONTACTS

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*

HEALTH HISTORY

Full disclosure is appreciated here.

Are you fully immunized?*

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*

STAFF AGREEMENTS

Please review the agreements below before signing.

1. Camp Policies & Risk Acknowledgment*

I acknowledge ADTC policies, including prohibited items/behavior, camper communication rules, and disciplinary expectations. I understand the inherent risks of camp participation and agree to follow all policies.

*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 and agree to ADTC Camp Policies & Risk Terms

2. Staff Contract Terms*

I understand that my ADTC contract is at-will and contingent upon a background check, training, and camper enrollment. I acknowledge that sessions may be canceled due to low enrollment or other factors.

I have read and agree to the Staff Contract Terms

3. Health & Safety Responsibilities*

I understand my responsibilities related to camper health and safety, including emergency response (e.g., EpiPen use) and communicable illness precautions.
How to Use an EpiPen Video

I have read and agree to the Health & Safety Responsibilities

I have watched the EpiPen training video

4. Conduct & Behavior Expectations*

I agree to uphold ADTC's standards of professionalism, respect, inclusion, and positive role modeling. I understand expectations around behavior, communication, and interactions with campers and staff.

I have read and agree to the Conduct & Behavior Expectations

Staff Digital Signature*

First Last

Today's Date*