Big House Application Form

Big House Application Form Basic Info: Name of Applicant: ______Phone: ______Church: ______Street Address: ______City: ______State: ______Zip Code: ______E-mail Address: ______Age ______Grade: ______School: ______Date of Flight I would like to serve on: ______Arriving when?______Departing when?______Getting to Know You: Original Flight #: ______Served before in BH? ______If so, how many times? ______Spiritual Gifts: ______Talents: ______Favorite Icebreakers/Games: ______Circle the areas of service that most interest you & cross out the ones where you won’t excel: Arts and Crafts Decorating Cooking Praying Leading Worship Public Speaking Creating Skits/Entertainment Leading Devotions Serving Meals Organizing Teaching Others Big House Information

 Any Chrysalis youth may apply for the Big House.  Youth will be asked to assist adults in charge of the Big House through the weekend. You will not leave the camp unless Big House adult requests you do so.  Applications will be processed on a first come, first served basis. Please email or mail this application to Emily Roach to reserve your spot so we will enough beds and food. If you come without reserving a spot ahead of time, you may be able to stay the night in Big House, but it is not guaranteed. Please bring your fee of $40 when you come to camp along with an updated background check if you are at least 18 years old (If you already have a background check, bring a copy - background checks expire after three years). We need your reservation email application no later than one week prior. Scholarships are available upon request.  Please come prepared to SERVE! Bring semi-formal clothes to wear to serve the special dinner on Day 2 of the flight. No short, strapless or halter dresses; no tight, revealing or offensive clothing. If you feel your clothes may be questionable, have a backup – you may be asked to change.  If you are staying in Big House you are not to drive to Candlelight unless you are 18 years of age or older. There will be adults available to drive you to Candlelight and back to camp. This is for your safety. You are not allowed to ride with anyone under 21 years of age.  Please realize this is a Christian environment and you are here to serve. We ask for you to refrain from any behavior that would not be acceptable in Christ’s eyes. You may be asked to leave if such behavior is not acceptable.  Smoking is not allowed on the premises of Camp Carefree per camp rules for youth and adults. Parent’s permission My child, ______, has my permission to participate in the support team activities of Piedmont Chrysalis for the above named dates. During this time I may be reached at the following phone number(s): Home: ______Cell: ______Other: ______Parent’s Signature: ______Date:______**Please attach copy of youth’s health insurance card** I promise to participate fully and support team activities of the "Big House". I understand my service begins at sponsor’s hour on Day 1 and ends following Closing on Day 3. I am willing to commit my service work and prayer for this weekend to the advancement of God’s kingdom. Applicant’s Signature______Date: ______

Please return your completed application Lewisville, NC 27023 to: or Emily Roach [email protected] 1836 Ellison Creek Road Make checks payable to: Piedmont Chrysalis – Big House Questions please call: 336-345-8678