2023 Part-time Volunteer Application

Full Name*

First Name Last Name

Birth Date*

Month Day Year

Address*

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

E-mail*

Social Security Number *

Home Phone*

Area Code Phone Number

Work/Cell Phone

Area Code Phone Number

T-Shirt Size (all sizes listed are adult sizes)*

Do you have any children age 12 or younger who would be part of our Day Camp program?*

Yes (please provide child's name & age below.)No

Child's Name

First Name Last Name

Age

Child's Name

First Name Last Name

Age

If more than 2 children, please provide other children's names & ages here:

What position(s) are you volunteering for at Hope of the Ozarks?*

Which camp(s) would you like to serve at?*

Teen Boy's Camp - June 11-16Teen Girl's Camp - June 18-23Junior Boy's Camp - June 25-30Timothy Training Camp - July 2-7Junior Girl's Camp - July 9-14Junior Boy's Camp - July 16-21Junior Girl's Camp - July 23-28Foster Kid's Camp - July 30-August 4

Name*

E-mail*

Phone Number*

Area Code Phone Number

Name*

E-mail*

Phone Number*

Area Code Phone Number

Jobs you had over the past 3 years:*

Are you certified in:

First AidCPRLifeguarding

If you are certified in any of the above areas, please list the expiration dates of these certifications:

Have you ever experienced any significant physical or emotional stresses within the past year, such as the loss of a parent, spouse, or child, extreme ill health? If so, explain briefly explain.*

Have you ever physically or sexually abused a child?*

Has anyone ever accused you of abusing a child?*

Emergency Contact

Phone Number

Area Code Phone Number

Do you have any allergic reactions to food, drugs, or insect stings?

YesNo

If so, please describe:

Do any of these affect you:

EpilepsyDiabetesAsthma

Do you have any medical conditions that might effect your time of service?

Commitment and Release

This is a serious commitment. Please ask God to help you overcome any obstacles that may arise in order to be able to fully carry out your commitment.

I am committed to serving at Hope of the Ozarks with all my heart and energy for the full time of service. The only thing that will keep me from this commitment would be a serious health issue or a family emergency.I accept the risks involved in camp activities and do hereby release Hope of the Ozarks, and all staff and volunteers, from any and all claims for injuries or death sustained by me or my family, whether such injury occurs on or off the camp property.I have read the Camp Policies and will uphold them and submit to the leadership of Hope of the Ozarks.I give permission to Hope of the Ozarks to use camp pictures or videos including myself in promotional and sponsorship material.I understand that Hope of the Ozarks is not responsible for lost clothing or personal property while I am at camp.I understand the mission for Hope of the Ozarks is to provide a Christian Camp where one can experience love, find hope, and grow in a relationship with Jesus Christ. I agree to respect the Statement of Faith for Hope of the Ozarks during my time of service.

I hereby state that I am 18 years or older, and I authorize the release of any criminal history record information to Hope of the Ozarks.

YesNo

By typing my name in this box, I agree to the above statements:*

If applicant is under 18 years old, a parent must type their name in this box to give consent:

2023 Part-time Volunteer Application

References

Skills & Experience

Emotional Health & Background

Medical Information: