Volunteer

Volunteer Fee of $40

The volunteer fee is to pay for the t-shirt and help cover the cost of additional food. If it is a financial strain on your family, please contact us at marianscamping@gmail.com

Volunteer Fee

$40.00

I'm a kitchen helper or nurse

$ Free Quantity

I'm a priest of God.

$ Free

Total

$0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Liability and Consent Form
I agree, on behalf of myself, my heirs, assigns, executors, and personal representatives, to defend, protect, indemnify and hold harmless Camp Kateri, the Marian Sisters of the Diocese of Lincoln, its officers, directors, agents, employees, volunteers, or representatives from any and all claims arising from my negligence or fault, and for any claim or cause of action whatsoever for liability for damages, illness, injury, or death arising from or in connection with my participation in Marian Camp. If any portion of this agreement is held invalid, it is agreed that the balance thereof, shall continue in full legal force and effect.

In the event that I should require medical treatment and I am not able to communicate my desires to attending physicians or other medical personnel, I give permission for the necessary emergency treatment to be administered. Please advise the doctors that I have the allergies and/or medical condition listed below on this form.

I am the individual listed below and have the authority to execute this Consent and Release on behalf of myself.
I have read and agree to the above statement.*

YES
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Birth date *

MonthDayYear
Date
COVID-19
By submitting this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that I possibly be exposed to or infected by COVID-19, by participating in this event, and that such exposure or infection may result in personal injury, illness, permanent disability, and even death. I understand that the risk of becoming exposed to or infected by COVID-19 at the event may result from the actions, omissions or negligence of myself and others, including but not limited to, employees and volunteers of the Marian Sisters of the Diocese of Lincoln. I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to my myself, including but not limited to, personal injury, disability, death, illness, damage, loss, claim, liability or expense, of any kind, that I may experience or incur in connection with my attendance at this event. I hereby release, covenant not to sue, discharge and hold harmless the Diocese of Lincoln, Marian Sisters of the Diocese of Lincoln, their employees, volunteers, agents and representatives of and from any and all claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto unless due to the gross negligence on behalf of Marian Sisters of the Diocese of Lincoln. I understand and agree that this release includes any claims based on the actions, omissions, or negligence of any of the foregoing persons or entities, its employees, volunteers, agents and representatives, whether a COVID-19 infection or communicable disease occurs before, during or after participation in this event.
I have read and agree to the above statement.*

YES
Medical Matters

I hereby warrant that to the best of my knowledge I am in good health.
Emergency Contact Name 1*

First NameLast Name
Relationship*
Main Phone Number of Contact*
Please enter a valid phone number.
Secondary Phone Number of Contact*
Please enter a valid phone number.
Emergency Contact Name 2*

First NameLast Name
Relationship*
Main Phone Number of Contact*
Please enter a valid phone number.
Secondary Phone Number of Contact*
Please enter a valid phone number.
Family Doctor*
Doctor's Phone Number*
Please enter a valid phone number.
Family Health Insurance Carrier*
Policy #*
Signature*

Clear

Specific Medical Information

I hereby warrant that to the best of my knowledge I am in good health.
Specific Medical Information: The Diocese will take reasonable care to see that the following information will be held in confidence.

Authorization for Administration of Medication Policy: While on Camp Kateri property, please keep all medications in a safe place where campers cannot access them (i.e. locked car, adult-only sleeping quarters). You can request to store medications in the nurse's station.
I have read and agree to the above statements.*

YES
Known Allergies?*
Immunizations: Date of last Tetanus/diphtheria immunization*
Do you have a medically prescribed or special diet? If yes, please describe.
See note on the next page.
Do you have any physical limitations? If yes, please describe.
Are there any special medical conditions we should be aware of?*

Dietary Needs

We are fortunate to make the delicious camp meals on site! However, as you are registering we wanted to bring to your attention the ingredients that most of our meals contain: ground beef, noodles, and a few items with cheese. The reason for this is two-fold, these items are cost effective for running an affordable camp and they are what the girls enjoy. These meals fill the girls up and give them energy to have fun. If you have a special diet and feel these foods will not work for you, please bring additional food*. There is room in the fridge in the kitchen to store items. If you are reading this as a dad of a daughter who is on a special diet, Sr. Benedicta, our cook will reach out to you. We are typically able to accommodate the special diets of campers.

*If your diet is strictly gluten free and/or dairy free, please mark that below. We typically have other campers/counselors with those needs and will be making something for them and can include you in the count.
Please select if the following needs apply to you.

Strictly gluten freeStrictly dairy freeOther and will bring my own food.

Photo and Media Release
I hereby give my consent for the Marian Sisters of the Diocese of Lincoln, the Catholic Diocese of Lincoln, any Religious Order within the Catholic Diocese of Lincoln, and any Third-Party Media Outlet approved by the Diocesan Ministry, to record, film, photograph, audiotape, or videotape my name, image, likeness, spoken words, work, performance or movement, in any form at the diocesan ministry location or a diocesan ministry-related activity or event (hereinafter collectively referred to as “Diocesan Ministry Works”), and to display, publish, post, reproduce, disseminate, or exhibit these Diocesan Ministry Works or any part thereof in connection with any promotional material, website, social media posting, radio broadcast, television broadcast, or any other media form or format. The Diocesan Ministry, Catholic Diocese of Lincoln, Religious Orders within the Catholic Diocese of Lincoln, and Third-Party Media Outlets approved by the Diocesan Ministry shall be collectively referred to as the “Approved Parties”.

I hereby release the Approved Parties, including their respective officers, directors, employees and agents from any and all liability, loss, damage, costs, claims and/or causes of action arising out of or related to the creation, publication, posting, reproduction, dissemination, or distribution of the Diocesan Ministry Works.

I have read this Media Consent and Release and understand its terms. I am the individual listed below and have the authority to execute this Consent and Release on behalf of myself.
My Name*

First NameLast Name
Select your preference*

I DO consent to the above statement.I DO NOT consent to the above statement.
Signature*

Clear

Safe Environment

Must be completed no later than June 8
The Diocese of Lincoln requires that all adult volunteers complete or renew the "Safe Environment Training" each year and a background check every five years.

See instructions below.
If you have already renewed your Training, please upload your most recent certificate below or email it to marianscamping@gmail.com.

Cancelof
Should be Empty:

Volunteer

Registration Information

Volunteer Fee of $40

Liability and Consent Form

Medical Matters

Specific Medical Information

Photo and Media Release

Safe Environment