Info for Adult Leaders

Instructions

ALL CAMP VOLUNTEERS & STAFF MUST COMPLETE THE REQUEST FOR CRIMINAL RECORD CHECK FORM!

Complete the top section containing your name, address, etc.  Your signature and date is required under the ATTENTION YOUTH SERVICE PROVIDERS section. 

Kamp staff will complete the REQUESTING ENTITY section as well as the bottom section, PROCESSING FEE SCHEDULE AND METHOD OF PAYMENT.  Leave these sections blank.

Send forms to Kamp Keirsey,  10002 NW Route J, Amsterdam, MO 64723.

If you have a scanner available,  you may scan and email the form to: Bill Perkins at kkorba@ckt.net.