23800 Parallel Rd, Tonganoxie, KS 66086

(913) 845-2586

Camp Mount Hermon

Church of the Brethren
Western Plains District

CoB Volunteer Staff Forms

Checklist of Required Documents

Because Camp Mount Hermon is a childcare facility, the following documents MUST be on file for all staff at least two weeks before camp begins. Staff orientation is provided at the beginning of each camp week.


  1. Volunteer Staff Application
  2. Reference Form (from three references)
  3. Background Check Release Form
  4. Health Form
  5. Copy of health insurance card (front and back)
  6. Copy of driver's license (front and back)

Staff Applications

Volunteer staff need only apply once per camping season. Please complete the volunteer staff application online and submit accompanying paper documents to the specified locations below. 

Click HERE for Volunteer Staff Application

Click HERE for Counselor-In-Training (CIT) Application

Reference Forms


Reference forms are valid for 10 years. Staff are required to have three (3) references (non-family members) complete on the District's reference form. Reference forms can be found HERE at the Western Plains District website.

Background Check Release Form

Background checks are valid for five (5) years. Please print and send completed form to Western Plains Church of the Brethren District Office, PO Box 394, McPherson, KS 67460 or scan and e-mail completed form to wpdcb@sbcglobal.net.​  Click HERE for Background Check Release Form.

Health Form

Health forms are valid for 24 months. Please print and submit the completed form to your camp director, along with copies of your insurance card and driver's license.​  Click HERE for Staff Health Form.