Camp_DASH_Volunteer_Application 2023

VOLUNTEER APPLICATION

To be completed by the applicant and signed by parent/guardian.

Name*

First Name

Last Name

Address*

Address Line 1

City

State

ZIP Code

Home Phone*

Applicant's Cell Phone*

If accepted into the program, applicants will be added to our "Remind" contact list. "Remind" is a application designed for Teachers, Coaches and Camp Coordinators that allows us to mass text all of our volunteers.

Email*

Date of Birth*

Age*

Preferred Pronouns

Shirt Size*

What Camp DASH site would you like to volunteer?*

Oswegathcie Elementary School Quaker Hill Elementary School

Have you ever been convicted of a crime in the past ten years, excluding misdemeanors and summary offense, which has not been annulled, expunged or sealed by court?*

No Yes

If yes, please describe in full:*

Do you have any allergies or medical needs?*

No Yes

If Yes, please describe in full:*

Do you have any prior commitments in which you may not be able to volunteer? (Sports, Work, Family, Planned Vacations etc.)*

Special Work or Qualifications:

Previous Volunteer Work: (If any)

What skills or qualifications do you have as a volunteer? (Other activities such as hobbies or sports)*

Anything about yourself you would like us to know or have interest in?*

Emergency Contact Information

Emergency Contact #1*

First Name

Last Name

Address for Emergency Contact #1*

Address Line 1

City

State

ZIP Code

Home Phone for Emergency Contact #1*

Cell Phone for Emergency Contact #1*

Email for Emergency Contact #1*

Emergency Contact #2*

First Name

Last Name

Address for Emergency Contact #2*

Address Line 1

City

State

ZIP Code

Home Phone for Emergency Contact #2*

Cell Phone for Emergency Contact #2*

Email for Emergency Contact #2*

References

Reference #1*

First Name

Last Name

Phone for Reference #1*

Email for Reference #1*

Reference #2

First Name

Last Name

Phone for Reference #2

Email for Reference #2

Reference #3

First Name

Last Name

Phone for Reference #3

Email for Reference #3

Signatures

Signature of Applicant *

[clear]

Use your mouse or finger to draw your signature above

Name of Parent, Guardian, or Authorized Agent *

First Name

Last Name

Signature of Parent, Guardian, or Authorized Agent *

[clear]

Use your mouse or finger to draw your signature above