2025 Camp Memiki Volunteer Application

Camp Memiki Volunteer Application

To apply to become a Camp Memiki volunteer for September 27, 2025 from 9:00am to 3:00pm, please complete this form.
All camp volunteers will need to attend a one-hour training session provided by Hospice.
Name*

First NameLast Name
Date of Birth*

MonthDayYear
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Emergency Contact*

First NameLast Name
Relationship*
Describe your experience with kids (personal or professional)*
Are you currently employed?

YesNo
Where are you employed?
References
Reference 1*

First NameLast Name
Relationship*
Phone Number*
Please enter a valid phone number.
Reference 2*

First NameLast Name
Relationship*
Phone Number*
Please enter a valid phone number.
Previous experience with death/loss?
Personal Interests/hobbies*
Please select the volunteer opportunity you are most interested in:*

I would like to be a buddy at Camp (All day commitment to the child you are with)I would like to be a Helper at Camp (Can be all day or for part of the day)I will go where needed
I would like to be a buddy at Camp (All day commitment to the child you are with)?*

YesNo
I would like to be a Helper at Camp (Can be all day or for part of the day)?*

YesNo
I will go where needed.*

YesNo
Please select the timeframe in which you can volunteer:*

9 am to 3 pm (all day)9 am to 12 pm (half day morning)12 pm to 3 pm (half day afternoon)Other
Please type what times you are able to come.*
(Ex: 9am-10:30am, 1pm-2pm)
T-Shirt Size*
Is there anything else we need to know?
Date of Birth*

MonthDayYear
Date
I give Good Samaritan permission to release my picture and information concerning my volunteer work to the media as needed*

Agree
Should be Empty:

Camp Memiki Volunteer Application

References