Civitan's Camp Big Heart 2024 Volunteer and Staff Application

Civitan's Camp Big Heart 2024 Volunteer and Staff Application

Apply here for activity leader, unit leader, volunteer, and lifeguard positions
If you have any questions please contact:
- Hillary at hillary.moore@campbigheart.org or 229-444-2487
- Stewart at stewart.smirthwaite@campbigheart.org or 228-327-5116
Identifying and Contact Information
Name*

First NameLast Name
Birth Date*

MonthDayYear
Gender*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail is one of the main ways we will contact you. Please list an e-mail account that you will check regularly between now and camp.
E-mail*
example@example.com
Phone Number*
Alternate Phone Number
Your picture file must be named Firstname_Lastname
Recent Photo*

Cancelof
T-Shirt Size (shirts are in mens sizes)*

SmallMediumLargeX-LargeXX-LargeXXX-Large
Desired Position
For a description of each position, check out http://campbigheart.org/staff/. If you have any questions please contact:
- Hillary at hillary.moore@campbigheart.org or 229-444-2487
- Stewart at stewart.smirthwaite@campbigheart.org or 228-327-5116
Participants must at minumum be a rising ninth grader at time of camp.
Desired Position*
If your first choice was anything other than Volunteer, we recommend you let us know what your second choice position is. Feel free to elaborate about your position preferences in your brief essay below.
Second Choice Position (Optional)
Third Choice Position (Optional)
If applying for Activity Leader, please list activities you are interested in leading. Traditional camp activities include arts & crafts, music, sports, and other exciting options!
Desired Session(s) Choose all that apply*

SESSION 1: June 8-14 (Adults Week (18 & up))SESSION 2: June 16-21 (School Aged Camper Week)
Have you worked at Camp Big Heart before?*

YesNo
How many years and in what positions?
Who were your previous unit leaders & volunteers?
Emergency Contact
Full Name*

First NameLast Name
Phone Number*
Relationship*
Education and Work Experience
What is your current occupation or year in school?*
Which of these best describes your education history as of June 1, 2024?*

Current High School StudentHigh School GraduateCurrent College StudentCollege GraduateOther
NEW MEMBERS: If this is your first time at camp, fill out the following sections.
Describe any WORK experience you have had including employer, position, and dates of employment.
Describe any CAMP experience you have had including employer, position, and dates of employment.
Describe any experience you have working or interacting with members of the special needs community.
Provide a non-family member reference below for us to contact. This can be a teacher, coach, mentor, or previous employer.
Full Name

First NameLast Name
Relationship
Time Known
E-mail
example@example.com
Phone Number
Certifications and Skills
Are you certified in first aid or CPR? List any certifications you will have during camp. Include cert name, issuing agency, and the exp. date.
Regardless of formal training, many members of our staff bring considerable experience and expertise. Please describe the relevant skills that you will bring to camp in as much detail as you'd like to share.
How did you hear about Camp Big Heart?
Medical Information
Please list any allergies you have.
Are you a vegetarian who requires vegetarian meals?*

YesNo
Describe any other dietary restrictions you have.
Medical History (check all that apply)

Seizure DisorderActive SeizuresDiabetesHeart Problems
Please list any other health conditions that may limit your ability to perform your duties at Camp Big Heart.
Medical Insurance

MANDATORY- You must upload a copy of your insurance card (front and back) to complete your application. If you currently do not have health insurance, please write N/A in the boxes below.
Insurance Company*
Contact Number*
The picture files you upload for your insurance must be named Firstname_Lastname_Front and Firstname_Lastname_Back. This naming convention must be followed to insure your application is processed.
Insurance Card (Front)*

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Insurance Card (Back)*

Cancelof
Essay
Explain why you want to work at Camp Big Heart, why you want your desired position, and why you'll be effective in that role. Also, this is your opportunity to tell us anything that you feel we should know in evaluating your application.*
Photo Release

I agree to allow photography of the applicant to be used by the Camp Big Heart and/or Camp John Hope for any publicity and/or promotional and/or educational purposes including leaflets, flyers, brochures, television, newspapers, magazines, advertisements, audio-visuals, videos, etc. This furthers the aims of Civitan’s Camp Big Heart to provide a summer recreational camp for our campers who are mentally challenged at a low cost to the participants, the majority of costs of said camp being underwritten by the Camp Big Heart Civitan Club.
I have read and agree to the Photo Release terms*

Check to confirm
Alcohol/drug use

I understand that alcohol and/or illegal drugs of any kind are NOT permitted on campus at any time. If it is discovered that I am using alcohol and/or illegal drugs of any kind on campus, I understand that those actions are grounds for immediate dismissal from Camp Big Heart and a possible one year suspension from working at Camp Big Heart the following year. I also understand that it is my sole responsibility to make sure that any prescription medications that I bring on campus are safely and discreetly placed in my luggage at all times. CAMP BIG HEART IS NOT RESPONSIBLE FOR ANY STAFF AND/OR VOLUNTEER MEDICATIONS.

Vaping/Smoking

I understand that the use of cigerattes, e-cigerattes, vapes, and other related products are to be used outside and out of the sight of campers. Cigerattes and other tobacoo based products, must be used in designated areas at the campsite. Any smoke or vape related products are not to be on my person while I am with campers and are to be charged with portable charges hidden away or in buildings where there are currently no campers. A camper should never see a vaping/smoking device or product, should never see the smoke or vaper from its use, or smell the use of the product.
I have read and agree to the above terms*

Check to confirm
Transportation

I understand that the applicant’s transportation to and from Camp Big Heart is my responsibility. The applicant and/or legal guardian will be responsible for transportation, as well as room and board arrangements for the Friday evenings after each session, as no one will be allowed to remain on campus. CAMP BIG HEART IS RELEASED FROM RESPONSIBILITY FOR ALL STAFF AND VOLUNTEERS DURING THE ABOVE MENTIONED TIME PERIOD.

Preplanning Sessions

I understand that all staff and volunteers are required to attend the staff orientation for each session they will be working. These will take place on Saturday afternoon on the first day of each session. We will specify what time you should be there well in advance of camp by e-mail.

Sleeping Accomodations

I understand that all staff and volunteers will be required to sleep on the top bunks of bunk beds. This leaves the bottom bunks for campers to use. I accept that accomodations will not be made for any bed preferences.
I have read and agree to the above terms *

Check to confirm
I attest that all of the given information is true to the best of my knowledge. I consent for Camp Big Heart to perform a complete background check. I also agree to abide by the rules and regulations set forth in the Camp Big Heart Manual and by the Camp John Hope Administrators.
Signature of Applicant*

First NameLast Name
Date*

MonthDayYear
Signature of legal guardian, if applicant is a minor

First NameLast Name
Date

MonthDayYear
Should be Empty:

Civitan's Camp Big Heart 2024 Volunteer and Staff Application

Identifying and Contact Information

Desired Position

Emergency Contact

Education and Work Experience

NEW MEMBERS: If this is your first time at camp, fill out the following sections.

Certifications and Skills

Medical Information

Essay