YMCA Camp Hi-Rock
A Branch of the Central Connecticut Coast YMCA

Camp with Character, Programs with Purpose since 1948

Complete All Steps and Read Carefully Before Arrival (downloadable version here)
-(Assuming your offer of employment is finalized, you will need to complete and understand the following before arriving and beginning your employment at camp)

Send all forms to the Director of Administration: admin@camphirock.org

These steps are necessary for all staff unless otherwise noted. You cannot begin work until all these steps are completed and verified by our office.

1. What other paperwork will I need to provide or complete before I will be allowed on site?
(Read: You must submit these forms to camp BEFORE you are scheduled to arrive!)

YMCA Camp Hi-Rock Medical Form (two-sided):

-Each staff member and volunteer must submit a complete Camp Hi-Rock Medical History Form. Even if your hiring agency provides a medical form, it is your responsibility to make sure that Camp Hi-Rock has proof of any necessary medical information as listed below. The health history form must include any allergies, required medications, and any health conditions or impairments which may affect your activities while attending the camp. It must also include the name, address and telephone numbers of the health care provider and health insurance provider, as well as emergency contact information that will be accurate during the summer.
-Staff members under the age of 18 must have their medical history form signed by a parent and a licensed health care provider. A parent or guardian must sign the form authorizing the camp or other medical professionals to provide emergency or other medical care.
-Staff members who are 18 or older must sign the form themselves in the place of a parent.

-A licensed physician must fully complete the immunization record section of the form. This form must show that the staff member is in compliance with the vaccination requirements detailed below:
--For staff younger than 18 years of age:
-Measles, Mumps and Rubella (MMR) Vaccine: A minimum of one dose of MMR vaccine must be administered at or after 12 months of age. A second dose of live measles-containing vaccine given at least four weeks after the first, is required for all staff under the age of 18 who will be entering grades K-12 or college in the school year immediately following the camp session. Laboratory evidence of immunity is acceptable.
-Polio Vaccine: A minimum of three doses of either inactivated polio vaccine (IPV) or oral polio vaccine (OPV) are required. If a mixed (IVP/OVP) schedule was used, four doses are required.
-Diptheria and Tetanus Toxiods and Pertussis Vaccine: A minimum of four doses of DTaP/DTP/DT or at least three doses of Td is required. Where a camper or staff person is seven or more years of age and requires additional immunizations, Td is to be substituted for DTaP, DTP or DT vaccine. For all staff who will be entering grades 11 and twelve a booster of Td is required if it has been more than ten years since the last dose of DTaP/DTP/DT/Td.

--For staff 18 years of age or older:
-Measles vaccine: Unless born before 1957, two doses of live measles-containing vaccine administered at/or after 12 months of age (at least four weeks apart) are required. Laboratory evidence of immunity is acceptable.
-Mumps vaccine: Unless born before 1957, at least one dose of mumps vaccine administered at/or after 12 months of age is required. Laboratory evidence of immunity is acceptable.
-Rubella vaccine: Unless born before 1957, at least one dose of rubella vaccine administered at/or after 12 months of age is required. Laboratory evidence of immunity is acceptable.
-Diptheria and Tetanus Toxoids: At least three doses of DTaP/DTP/DT/Td are required. A booster dose of tetanus/diphtheria, adult type toxoid (Td) is required if more than ten years have elapsed since the last dose of DTaP/DTP/DT/Td vaccine.

Medication Administration Release Form (staff under 18 only):

-If the staff member is under the age of 18, he or she must provide the camp with a complete medication administration release form signed by the parent/guardian and by the prescribing physician, authorizing the camp medical personnel to administer any medication they bring with them to camp and detailing the instructions for dosage and other relevant details of the manner in which the medication should be administered.

Physical Examination (part of YMCA Camp Hi-Rock Medical Form):

-Before arriving at camp, all staff must provide the camp with a report of physical examination conducted within the 24 months prior to their last contracted work day, and should use camp’s medical form to document that physical examination.
-The physical examination form must show documentation by a physician that the staff member is not known to be suffering from tuberculosis in a communicable form, or have evidence of symptoms thereof. Anyone who is known to be suffering from tuberculosis in a communicable form, or to have evidence of symptoms thereof, shall not be allowed to work or volunteer at Camp Hi-Rock.

2. What other paperwork will I need to provide or complete before I will be allowed to begin work at camp?
(Read: You should print and submit these documents in ahead of time to avoid being prevented from working once you arrive!)

• Copies of certification documents verifying current certification in all required areas as designated on your Terms of Employment must be presented to the office to be copied for our records before you will be allowed to work. You may mail copies of these to camp ahead of time.
• Anyone under the age of 18 who has been hired for a paid position will be required to present working papers from their school before they will be allowed to work. If you are not familiar with working papers, please contact the camp office.
• All staff and volunteers must present their driver's license to be photocopied before they will be allowed to begin work. If you do not have a driver's license, this is not applicable.
• All staff and volunteers must sign and submit a copy of their job description before they will be allowed to work.
• • All staff and volunteers must sign a copy of their Terms of Employment and return it to camp before they will be allowed to work. Please print the terms of employment, sign them, and return them to camp prior to your arrival at camp.
• All American staff (staff not working under a J-1 visa) must complete and sign a Federal W-4 tax form and a Massachusetts M-4 tax form.
• All staff must sign and submit a Personnel Policy and Code of Conduct Receipt. Copies of the Personnel Policy and Code of Conduct are available here
• • All staff must sign a Web Code of Conduct.
• All American staff (staff not working under a J-1 visa) must complete and sign an I-9 form. Please complete and sign the form and return it to camp before your arrival at camp. Upon arrival at camp you will be required to present original forms of the identification required as described on the I-9 form. Please read the form carefully and be sure to bring the appropriate forms of identification with you. If you would like help determining what forms of identification will be acceptable, please call the camp office.

Send all forms to the Director of Administration: admin@camphirock.org

No one will be allowed to begin work at camp until the paperwork detailed above is complete. Please complete your paperwork and return it to camp as soon as possible so that we may process it and contact you if anything is missing, incomplete, or incorrect. There will not be time to address problems with the above once you arrive so please submit each piece of required paperwork as early as possible. Use the staff checklist page (staffchecklist.pdf) to help you keep track of your progress with these tasks.

Next: Paperwork Summary/Staff Paperwork Checklist

Previous: Paperwork You Must Complete FIRST

Visit the Central Connecticut Coast YMCA,
an Activate America YMCA

Welcome! We hope you will spend some time exploring our website. Camper forms and staff forms are available for downloading. We welcome any comments or questions you may have.
Emails can be sent to info@camphirock.org
We add new materials often, so please bookmark us and check back soon!

This camp must comply with regulations of the Massachusetts Department of Public Health and be licensed by the local board of health.