Camp Volunteer Application

Thank you for your interest in volunteering for

Camp Cell-A-Bration/Camp Next Level

Please be prepared to upload the following items with the application.

1. Copy of professional license (if applicable)

2. Copy of your certificate (CPR/First Aid)

**Notice to Camp Counselors/Volunteers with Sickle Cell Disease or other Chronic Conditions**

Camp Cell-A-Bration/Next Level counselors/volunteers are required to engage in physical activity such as walking up to a mile daily and requires the individual to be outside in a variety of weather conditions. Camp Cell-A-Bration/Next Level counselors/ volunteers are expected to care for the campers 24 hours a day while remaining healthy and physically able to complete all activities for the entire camp. Counselors with sickle cell disease or other chronic conditions must complete the medical release form in addition to this application.

Volunteer Information

Name*

First NameLast Name

Birth Date*

MonthDayYear

Gender*

MaleFemale

T-Shirt Size*

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Email*

Emergency Contact Information

Emergency Contact's Name*

First NameLast Name

Relationship

Phone Number*

Area CodePhone Number

Education / Employment Information

Name of High School

Did you obtain diploma/GED?

College Name

Did you obtain a degree?

Current Employer's Name

Current Employer Phone Number

Occupation

Current Supervisor's Name

References

Please give the names, phone numbers, and email addresses of two persons (not relatives) who have knowledge of your character, experience and ability:

Reference 1

First NameLast Name

Email

example@example.com

Phone Number

Area CodePhone Number

Reference 2

First NameLast Name

Email

example@example.com

Phone Number

Area CodePhone Number

Background Information

Have you ever been convicted of a crimal offense?*

Have you ever been charged with child abuse or neglect?*

Are you currently on probation, deferred adjudication or form of shock probation?*

Have you ever been fired for cause or asked to resign a job or suspended or expelled from scholl for assul, drug possession, weapons or another dangerous crime? *

Has your driver's license ever been suspended or revoked?*

If Yes, please expain to any of the above questions:*

Other than the above questions, is there any other circumstances involving you or your background that may call into question you working with children? If Yes, please expain:*

Camp Volunteer / Skills Information

What camp are you planning to volunteer?*

Camp Next Level (March 14-16, 2025)Camp Cell-A-Bration (July 27-August 1, 2025)

Here are some of the possible areas to volunteer in at Camp Cell-A-Bration/Next Level. Please check any that you have experience in and would be interested in helping with:*

How did you hear about Camp Cell-A-Bration/Next Level?

Have you worked at a childrens camp before?

If Yes, please list the Camp Name and your duties:

Do you have experience working with children?

If Yes, please explain:

Do you have experience working with special needs children?

If Yes, please explain:

Describe your goals and/or expectations as a volunteer:

Are you certified in: (Please select all that apply)

CPRFirst Aid

Please upload your certificate

Browse Files

Profession (check all that apply)

Specialty

PediatricsAdultsTeensOther

License Number: (If Applicable)

State Licensed: (If Applicable)

For medical professionals only, have you had a grievance, suspension or termination of your license?

If Yes, please explain:

Please upload copy of medical/professional license:

Browse Files

Please list any other info that would be helpful for us to know (ex. other skills, how much skill you have in certain areas, work limitations, etc):

Medical Information

This information is kept confidential, along with all application materials. This section is only used to help you in the event of an emergency.

Name of Doctor/Clinic

First NameLast Name

Doctor/Clinic Phone Number

Area CodePhone Number

Health Insurance Information

Name of InsuranceGroup / Policy Number

Please list medications you take daily. Please include the medication name, dosage and how many times per day each is taken. (It is your responsibility to take your medications during camp.)

Health or Behavioral Conditions:

Dietary Needs/Restrictions:

Drug Allergies or Other Allergic Reactions (food, animals, medication, insects ect):

Activity Restrictions:

Code of Ethics & Code of Conduct

Volunteers must comply with this Code of Ethics throughout placement with the Camp Cell-A-Bration/Next Level and affiliation with the sponsoring organization (Sickle Cell Association of Marc Thomas Foundation). This list is not exhaustive. Compliance with the Code of Ethics is a condition of continued involvement with the Camp. I understand that violation of the following standards will be regarded as engaging in unethical behavior which is grounds for IMMEDIATE TERMINATION AND DISMISSAL of roles and responsibilities.

Please initial each statement after reading.

Initial*   1. Staff/Volunteers understand and embrace the mission of the Camp and willingly and knowingly accept the concept that the focus and goals of the Camp are directed to the campers.
Initial*   2. Staff/Volunteers will never leave a camper unsupervised.
Initial*   3. Staff/Volunteers will never be alone with campers or a camper, except when assisting with personal hygiene or toileting which is permitted by specific Camp policies or in an emergency.
Initial*   4. Staff/Volunteers will not abuse campers including:
- Physical Abuse strike, spank, shake, slap
- Verbal Abuse humiliate, degrade, and threaten
- Sexual Abuse including inappropriate touching
- Mental Abuse hazing, negative manipulation
Initial*   5. Staff/Volunteers will use positive guidance techniques including redirection, anticipation of and elimination of potential problems, positive reinforcement, support and encouragement rather than competition, comparison, criticism, or humiliating discipline techniques.
Initial*   6. Staff/Volunteers must treat with confidence and respect personal information they learned from campers, subject to the policies on reporting abuse and neglect, as referenced elsewhere in the Camp Cell-ABration Manual.
Initial*   7. Staff/Volunteers will treat campers of all ethnic, religious and cultural backgrounds with respect and consideration.
Initial*   8. Staff/Volunteers will treat Camp Cell-A-Bration/Next Level Staff/volunteers/Camp for All Staff/volunteers with respect and consideration at all times. There will not be fights, arguments, pranks, entering other cabins without permission, touching other person’s personal items, taking Camp items or breaking/damaging items
of Camp and others.
Initial*   9. Staff/Volunteers will adhere to the Discipline Policy as stated in the Camp Cell-A-Bration/Next Level Manual.
Initial*   10. Staff/Volunteers will portray a positive role model for campers, including but not limited to, maintaining an attitude of respect, loyalty, patience, honesty, courtesy, tact and maturity at all times to all
patrons. Staff/Volunteers will not yell, act unruly, or cause a disturbance.
Initial*   11. Staff/Volunteers will not use profanity, curse words or discuss adult subject matter at Camp.
Initial*   12. Staff/Volunteers will adhere to the dress code for Camp Cell-A-Bration/Next Level.
Initial*   13. Staff/Volunteers will not use, possess or be under the influence of alcohol or illegal drugs during Camp.
Initial*   14. Staff/Volunteers are prohibited from having firearms or other weapons while at Camp Cell-A-Bration/Next Level.
Initial*   15. Staff/Volunteers must be free of health or psychological conditions that might affect campers’ health.
Initial*   16. Staff/Volunteers will comply with the outlined activities and expectations of their defined roles at Camp Cell-A-Bration/Next Level and all required activities prior to Camp which support their roles.
Initial*   17. Staff/Volunteers are prepared and willing to assist and support campers to meet personal daily needs.
Initial*   18. Staff/Volunteers will accommodate and be sensitive to the developmental differences and abilities of individual campers.
Initial*   19. Staff/Volunteers that do not have a pre-existing relationship with a camper will not fraternize with campers (baby sitting, phone calls, and private lessons) outside of Camp Cell-A-Bration/Next Level supervised activities or the Camp setting. Any exception to this policy requires written approval in advance from the SCAAMTF or Camp Director.
Initial*   20. Staff/Volunteers will not offer gifts or money to campers or their families.
Initial*   21. Staff/Volunteers are required by State laws to report any suspected abuse or neglect of a child to the Camp Director so that it may be reported to the authorities ( Department of Protective and Regulatory Services and local enforcement agency).
Initial*   22. Staff/Volunteers will not make personal disclosures to campers with an attempt to influence individual beliefs, values or lifestyles.
Initial*   23. Staff/Volunteers will adhere to the outlined policies, procedures and standards of Camp CellA-Bration.
Initial*   24. Staff/Volunteers must agree to provide all criminal and other background check information requested of them and must meet qualification standards established by the Camp Cell-A-Bration/Next Level.

Date

Signature

CAMP CELL-A-BRATION/Next Level VOLUNTEER GENERAL LIABILITY RELEASE, WAIVER, INDEMINIFICATION AN AGREEMENT NOT TO SUE

PARTICIPATION CONSENT: I, the undersigned, First Name* Last Name*, authorize my participation in CAMP CELL-A-BRATION/Next Level (“CAMP”), including all related activities. I fully understand all of the dangers, hazards and risk that are associated with and may occur as a result of my participation in the CAMP and related activities. These activities include, but are not limited to, the activities of horseback riding, high and low elements ropes course, swimming, archery, riflery, sporting activities, and canoeing. I understand that these activities are voluntary and I have familiarized myself with Camp Cell-A-Bration/Next Level’s Program and activities at Camp For All in which I will be participating. I understand that these dangers and risks may result in property damage, impairment to health and well-being, and/or physical injury, including serious or even fatal injuries. I acknowledge that although Camp Cell-A-Bration/Next Level and Camp For All have taken safety measures to minimize the risk of injury to camp participants, Camp Cell-A-Bration/Next Level and Camp For All cannot insure or guarantee that the participants, equipment, premises or activities will be free of hazards, accidents or injuries. I recognize and have been instructed in the importance of knowing and abiding by the rules, regulations, and procedures for Camp Cell-A-Bration/Next Level at Camp For All. I also agree to inform Camp Cell-A-Bration/Next Level of any activities in which I may not participate.

EXCULPATORY AND INDEMNITY CLAUSE. In consideration for being permitted to participate at CAMP (free of charge), I agree to assume full responsibility for all risks. I further agree to release, waive, agree to hold harmless and covenant not to sue Camp Cell-A-Bration/Next Level, and all purposes the Sickle Cell Association of Austin Marc Thomas Foundation a non-profit agency, and its board of directors, officers, agents, employees, volunteers, and Camp For All (referred to collectively as "Releasees"), from and against any and all liability, claims, demands, actions, causes of action, suits in equity, whatsoever arising out of or related to any loss, damage, or injury, including fatal injuries along with court costs and attorney’s fees and expenses whether caused as a result of sole, joint or concurrent negligence, negligence per se, statutory fault or strict liability of Releasees or otherwise, that may be sustained while participating in CAMP and CAMP related activities while in or upon the premises where the CAMP and related activities are being conducted or while being transported to, from or in connection with the CAMP. I understand this waiver does not apply to injuries caused by intentional or grossly negligent conduct. I further agree to indemnify the Releasees from liability, claims, demands, actions, causes of action, or suits in equity arising out of loss, damage or injury that occurs as a result of my negligent or intentional act or omission while participating in CAMP and in related activities.

NO INSURANCE. I understand that Releasees may or may not maintain any insurance policy covering any circumstance arising from my participation in CAMP or any event related to that participation. As such, I am aware that I should review my personal insurance coverage. CAMP and SCAAMTF may not carry general liability insurance to cover claims arising from CAMP and CAMP activities so it seeks a waiver of claims as additional consideration for the right to participate so CAMP and the SCAAMTF, can (a) provide the CAMP free of cost to participants; and (b) to provide access to a greater number of participants by expending limited resources on program materials and activities rather than on liability insurance.

MEDICAL AUTHORIZATION, INDEMNITY FOR MEDICAL EXPENSES, and WAIVER. I understand Releasees cannot be expected to control all of the risks articulated in this form and Releasees need to respond to accidents and potential emergency situations. Therefore, I hereby give my consent for any medical treatment that may be required, as determined by a medical professional at an off-site medical facility or hospital, during my participation in this activity with the understanding that the cost of any such treatment will be my responsibility. I agree to indemnify and hold harmless Releasees for any costs incurred for my treatment, even if Releasees have signed hospital documentation promising to pay for the treatment due to my inability to sign the documentation. I further agree to release, waive, discharge, covenant not to sue, and agree to hold harmless for any and all purposes, Releasees from any and all liabilities, claims, demands, injuries (including fatal injuries), or damages, including court costs and attorney ’s fees and expenses, that I may sustain while receiving medical care or in deciding to seek medical care, including while traveling to and from a medical care facility, including injuries sustained as a result of sole, joint, or concurrent negligence, negligence per se, statutory fault, or strict liability of Releasees. I understand this waiver does not apply to injuries caused by intentional or grossly negligent conduct.

BINDS HEIRS. It is my express intent that this Release, Waiver, Indemnification and Agreement not to Sue shall bind myself, the other members of my family and spouse, if I am living, and my estate, family, heirs, administrators, personal representatives, or assigns, if I am not living.

AGREEMENT OF RELEASE AND VOLUNTARY SIGNATURE: In signing this Release, Waiver, Indemnification and Agreement not to Sue, I acknowledge and represent that I have carefully read the document and understand its contents and that I sign voluntary as my own free act and deed. CAMP and Releasees have not made and I have not relied on any oral representations, statements, or inducements apart from the terms contained in this agreement. I further state that I am at least eighteen (18) years of age and fully competent to sign; and that I have executed this Release for full, adequate, and complete consideration fully intending to be bound by the same.

Code of Ethics & Code of Conduct

Volunteers must comply with this Code of Ethics throughout placement with the Camp Cell-A-Bration/Next Level and affiliation with the sponsoring organization (Sickle Cell Association of Marc Thomas Foundation). This list is not exhaustive. Compliance with the Code of Ethics is a condition of continued involvement with the Camp. I understand that violation of the following standards will be regarded as engaging in unethical behavior which is grounds for IMMEDIATE TERMINATION AND DISMISSAL of roles and responsibilities.

Please initial each statement after reading.

Date*

Date

Signature*

Camp Cell-A-Bration/Next Level: Volunteer/Med Staff Application