Previous Employment & Direct Supervisor
Three References (non-relative)
Please Check all that apply to you and your health history
In order to travel with Engage you must comply with the regulations of the Massachusetts Department of Public Health which includes documented records of Immunizations, a Physical Examination, Concussion training, the CORI background check and SORI sex offender check. Without these records, you will not be eligible to travel as summer staff. Please complete the forms below by uploading the appropriate documents:
The Massachusetts Department of Public Health requires that every camper and full time staff person shall prior to attending camp, furnish to the camp a certificate of immunization, prepared and signed by a licensed health care provider:
Please upload a copy of your immunization records below.
The Massachusetts Department of Public Health requires that every camper and full time staff person shall prior to attending camp, furnish to the camp proof of a physical examination, prepared and signed by a licensed health care provider:
Please upload a copy of your Physical below.
The Massachusetts Department of Public Health requires that every full time staff person shall prior to attending camp, furnish to the camp proof of a concussion training certificate:
Process:
1. https://www.cdc.gov/headsup/youthsports/training/index.html
2. Click "Launch the HEADS UP course"
3. Complete the free training and you will receive the certificate, download it and upload it below before in order to submit and complete this form
Please upload a copy of your concussion training certificate below.
The Massachusetts Department of Public Health requires that every full time staff person shall prior to attending camp, have a background free of conduct that bears adversely upon his or her ability to provide for the safety and well-being of the campers. We are required to obtain a sex offender registry information check from the Massachusetts Sex Offenders Registry Board and a CORI/Juvenile Report from the Department of Criminal Justice Information Services.
*Other background checks outside of the CORI/SORI forms stated above do not meet the criteria of eligibility.
Process:
1. Download the CORI form below and print it out
2. Fill/sign the printed copy BY HAND and either scan it to your computer or simply take a picture of it on your phone and upload it below:
Lastly, please upload a copy of your ID as that is necessary to run the background check.
We will run the report with the information you provide on that form and let you know if you passed or failed the both background checks.
