Clone of Camp Kidney 2025 Volunteer Application

Camp Kidney 2026 Volunteer Application
WELCOME TO CAMP KIDNEY 2026

Camp Kidney will be held from Friday, October 23th through Sunday, October 25th at Camp Pinerock in Prescott, Arizona. Volunteers must be available/must commit to the entire weekend. Arrival on Friday, October 23th must be prior to our campers arrival at 2pm. We ask that all volunteers arrive at 10am. Departure on Sunday, October 25th will be after campers depart roughly around 1pm.

Below is the 2026 Camp Kidney Volunteer Application. Applications are due Monday, September 28, 2026. Late applications will not be accepted.

Returning volunteers will be given priority for the limited volunteer slots. New volunteers will be added in depending on the number of campers.

Thank you for giving your time and for being a part of the magic of Camp Kidney.
Required Pre-Camp Meeting:

Date & Location: Saturday, October 17th

Location: Mel Cohen Conference Room (Phoenix Childrens Hospital - 1919 E. Thomas Road)

10am - Campers & Families

11:30am - Staff/Volunteers/CITs/Med Team (lunch will be provided)

We ask that all volunteers attend the Camper/Family meeting too.

After the camper meeting, we will be meeting as a team for a more indepth discussion of the schedule/activities of camp as well as any camper notes from our Med Team.

Please let us know if advance if you are not able to attend this meeting. We will work with you to cover all the necessary information.

All volunteers must be over the age of 21. Please note that we do not allow any parents/guardians or siblings of campers to apply/attend camp as a volunteer.

We look forward to seeing you to Camp Kidney 2026!!
Volunteer Name:

First NameLast Name
Birth Date:

MonthDayYear
Gender
Mobile Phone Number:

Area CodePhone Number
Secondary Mobile Number:

Area CodePhone Number
Email Address:
Emergency Contact:

First NameLast Name
Emergency Contact Phone Number

Area CodePhone Number
Primary Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Secondary Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Upload Copy of Driver's License

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Medical Insurance Company
Policy Number
Upload Insurance Card Photo

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Select Camp Sweatshirt size:

Other
Select Camp Sweatpants size:

Other
If we were able to also purchase long sleeve shirts, please let us know if you would like the same size or different from the hoodie size above.
Please select the type of volunteering you wish to be part of:
Are you a returning Camp Kidney Volunteer?
As we have the most incredible volunteers, returning volunteers will be given priority for the coveted volunteering slots. This year we are looking for a total of 16 volunteers; ideally 8 male & 8 female. We will deterime the final number of needed volunteers based on the number of campers attending.
MEDICATION

For the safety of our campers, we ask that all volunteers provide information regarding their own medications and medical supplies. We also ask that all medications/supplies are kept out of access of all campers. Medications can be kept with you in your dorm or medications/supplies may be held with Med Team if preferred.

Medication Listing

Rows	Medication Name	Dosage	What time do you take the medication?
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.

Please list any medications not listed above.
Medical Questions
Allergies

Other
Do you have an Epi pen? If so, please bring to camp as we will not have access to an extra one.
If yes to any of the allergies above, please provide details:
Please provide information regarding symptoms and treatment for known allergies.
CPR Certified
If yes, please include date of certification.
Medical Supplies
List ANY & ALL supplies (e.g.; inhaler, epipen, etc) you will need/could need at camp- enough for 3 days and 2 nights.

Supplies List

Rows	Supply	Used For	Special Instructions
1
2
3
4
5

IMPORTANT:

Please know that YOU will be responsible to provide all medical equipment, medications and supplies for camp. Be sure to pack enough of everything to last 3 days and 2 nights at camp.
Please include any other medical information you feel the Med Team should be aware of.
Vaccination Policy & Updates

.
Due to the nature of our camper population, many of whom are immunocompromised, we ask that you help us in ensuring that Camp Kidney is a safe space for these campers by:

1. With the increase of Measles outbreaks around the United States, all volunteers MUST have received the MMR (Measles, Mumps & Rubella) vaccination.

Vaccination reccords can be obtained from your former peditrician's office or if you are an Arizona native, online at the Arizona Deptarment of Health Services https://irr.azdhs.gov/irr-form.php . Most states also have an online form to receive older immunization reccords.

If you are unable to obtain your reccords, a titer (blood draw/test) may be performed. NKF will pay for the lab costs. Please reach out to Ashleigh directly to schedule this.

2. Due to the nature of our camper population,Covid-19 vaccination including the recent booster is encouraged for your protection, but not required. Masking is optional, and welcome.

3. All Counselors/volunteers MUST receive the 2026/2027 Flu Vaccine prior to attending Camp Kidney. Please upload documentation below or email it directly to Ashleigh.

4. Any Camp Kidney participants experiencing cold or flu-like symptoms are encouraged to please refrain from attending Camp.

5. Due to the nature of our campers and their health and saftey, please complete the below section regarding Intigrated Tuberculosis (TB).

6. Reminder: Tetanus shots should be updated every 10 years.
Please sign acknowledging of the above.
Please upload any immunization documents

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Integrated Tuberculosis (TB) Screening and Risk Assessment Form for Camp Kidney Volunteers
Have you EVER spent more than 30 days in a country with an elevated TB rate? This includes all countries except those in Western Europe, Northern Europe, Canada, Australia, and New Zealand.
Have you had close contact with anyone who had active TB since your last TB test?
Do you currently have any of the following symptoms:
1. Unexplained fever for more than 3 weeks
2. Cough for more than 3 weeks with sputum production
3. Bloody sputum
4. Unintended weight loss >10 pounds
5. Drenching night sweats
6. Unexplained fatigue for more than 3 weeks
Have you ever been diagnosed with active TB disease?
Have you ever been diagnosed with latent TB infection or had a positive skin test or a positive blood test for TB?
Have you been treated with medication for TB or for a positive TB test (eg, taken “INH”)?
If YES, what year, with which medication, for how long, and did you complete the treatment course?
Do you have a weakened immune system for any reason including organ transplant, recent chemotherapy, poorly controlled diabetes, HIV infection, cancer, or treatment with steroids for more than 1 month, immune-suppressing medications such as a TNF-alpha antagonist or another immune-modulator? (If you are not sure, ask your primary care provider)

Conditions of Volunteering at Camp Kidney
1. Camp Kidney accepts no responsibility for the loss, damage, or theft of my property.

2. I understand that I will be covered solely by the medical insurance policy in which I am enrolled.

3. I authorize a licensed professional to dispense any medications recommended or prescribed by a physician during Camp Kidney.

4. I assume full responsibility for my safety. I agree to release and indemnify Camp Kidney, National Kidney Foundation of Arizona and all of their agents, representatives and employees (paid and volunteer) from any claims, costs, expenses and/or damages which I may sustain or incur.

5. If I have behaviors that are harmful to the camp community, I will be sent home. If I am asked to leave camp, it will be at my own expense. I acknowledge that I will be held financially responsible for acts of vandalism caused at Camp Kidney.

6. I agree to hold the professional staff of Camp Kidney, National Kidney Foundation of Arizona and all of their agents, representatives, employees and other volunteers free from any liability which may arise from any accident or illness at Camp Kidney.
All of the above information is correct to the best of my knowledge.
Printed Name

First NameLast Name
Signature
Today's Date

MonthDayYear
Date
Emergency Medical Treatment
In the unfortunate case of medical and/or surgical emergencies, I authorize National Kidney Foundation of Arizona’s medical volunteers to render or arrange for the person named below to receive any x-rays, anesthetic, medical, dental, surgical procedure, treatment or medical care which is deemed advisable by and is to be rendered under the supervision of any physician, dentist, or surgeon licensed in the state of Arizona.
Printed Name

First NameLast Name
Signature
Today's Date

MonthDayYear
Date
Media Consent
I give permission to Camp Kidney, National Kidney Foundation of Arizona, Camp Pinerock, and other media invited to camp by Camp Kidney/National Kidney Foundation of Arizona to take and release video footage and photography of the person named below during his/her time at Camp Kidney.

I understand that any video or photo may be used on television, in newspapers, magazines, internet, or in any other medium that National Kidney Foundation of Arizona and Camp Pinerock may choose.
Printed Name

First NameLast Name
Signature
Today's Date

MonthDayYear
Date
Alcohol, Tobacco & Drug Policy
National Kidney Foundation of Arizona and Camp Pinerock Policy forbid the possession or use of any alcohol, tobacco, and/or un-prescribed drugs any time while at Camp Kidney. Staff and volunteers who don’t comply will also be sent home. No exceptions will be made.

Your signature below indicates your commitment to abide by this policy in its entirety. Please contact the National Kidney Foundation of Arizona at (602)840-1644 if you have any questions regarding this policy.
Printed Name

First NameLast Name
Signature
Today's Date

MonthDayYear
Date

Background Check
Under a policy determined by the NKF AZ Board of Directors, all volunteers must complete and pass a standard backgound check. Upon completion of this application, a background check form will be emailed you to directly. NKF AZ will cover all fees associated with the background check.

Background checks will be done yearly for every Camp Kidney volunteer.

Please sign below that you acknowledge the policy and agree to the background check. Please reach out to NKF AZ directly with any questions or concerns regarding this policy.
Signature

Thank you for being part of the magic at Camp Kidney.

We are so greatful for your time, energy & dedication you give towards camp and it's campers.

We can't wait to see you in October.

Ashleigh & Jen

*If you were unable to upload any of the required documents, please email them directly to ashleighs@azkidney.org*
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Camp Kidney 2026 Volunteer Application

MEDICATION

Medical Questions

Medical Supplies

Vaccination Policy & Updates

Integrated Tuberculosis (TB) Screening and Risk Assessment Form for Camp Kidney Volunteers

Do you currently have any of the following symptoms:

Conditions of Volunteering at Camp Kidney

Emergency Medical Treatment

Media Consent

Alcohol, Tobacco & Drug Policy

Background Check