Camp Volunteer Registration

Held at Harnischfeger Park – A Dodge County Park in Ixonia, WI July 22-25, 2024

Please complete the form below.

Name(Required)

First Last

Name as it would appear on their nametag(Required)

Name

Gender(Required)

Male

Female

Address(Required)

Street Address Address Line 2 City State ZIP Code

Phone Number(Required)

Email(Required)

Enter Email Confirm Email

Age(Required)

Volunteers age 13 or under need to contact Bridget Bruno for available opportunities

Birthdate(Required)

MM slash DD slash YYYY

Parent's Name

If under the age of 18

First Last

Parent's Phone Number

If under the age of 18

Emergency Contact(Required)

Please list your emergency contact Name AND Phone Number.

Physician(Required)

Please list your primary care physician's name AND phone number.

Allergies(Required)

Please check ALL that apply.

None

Latex

Bee Stings

Environmental

Food

Medicine

Other allergies not listed above:

Allergens(Required)

If checked above, please list any specific allergies, and the type of reaction. Or write "None"

Life Threatening(Required)

Yes

No Allergies

Background(Required)

Have you ever been convicted of a felony?

Yes

Background Explain

If yes, please explain.

T-shirt size(Required)

Adult Small

Adult Medium

Adult Large

X-Large

XX-Large

Days(Required)

Which days are you available to help at camp?

All 4 days

Monday 7/22

Tuesday 7/23

Wednesday 7/24

Thursday 7/25

Child's Activity

If your child is a camper, would you like to be scheduled around his/her activities?

Yes

Not Applicable

List

If yes, which activities (ex. rockwall, fishing, lunch, etc.)

How did you hear about camp?(Required)

Experience(Required)

Please list any experience working with children with special needs.

CPR(Required)

Do you have current CPR or First Aid training?

CPR

First Aid

None

Volunteer Opportunities - ALL WEEK REQUIRED!!!

-Group Leader –age 18+ You are responsible for a group of up to 13 campers. You will be working together with parents, buddies and activity leaders to provide a quality camp experience. Group Leaders must be at camp all 4 days.

-Assistant Group Leader-age 15+ – You are responsible for assisting the group leader. This would be a good opportunity to train for a group leader position in the future.

-Provided Buddy - A family has requested yo to be their child's buddy at camp. You will be helping them participate in group activities to the best of their ability. You would be responsible for assisting campers with activities and helping to get them around the camp environment.

Volunteer Opportunities - FLEXIBLE DAYS

-Crafts-age 13+ - You would be leading and helping the groups during craft projects, and helping with set up and clean up.

-Fishing-age 14+

-Rock Wall-age 15+ You would be responsible for helping campers get set up for climbing, assisting with harnesses and helmets. (Tues. and Thurs. only)

-Horses-age 14+ Would like volunteers to have horse experience, responsible for assisting campers, side walking, etc.

-Kitchen-age 14+ - This would involve serving snacks and lunch to campers and volunteers, also set up and clean up.

-First Aid- This would involve administering medications, changing diapers, assisting with G-tube feedings, and tending to minor injuries that occur on the camp grounds.

-Co-Operative Games-Assist activity leader with various games and activities while working with each group as a cooperative team.

-Obstacle Course-Assist physical therapist with a theme related obstacle course.

-Grounds-age 25+ Help with transporting campers to and from activities, filling water coolers, collecting garbage, etc.

-Check-In- Need help Monday morning (8:30-10:00) checking in campers and volunteers

-Photography- age 14+ - Take group pictures and various pictures of activities at camp.

-Sensory Area-age 18+ You will be assisting campers who are having difficulty staying with the group. There will be a variety of options at this station.

1st Volunteer Choice(Required)

Please check ONLY ONE box for your first choice of volunteer position

Group Leader

Assistant Group Leader

Provided Buddy

Crafts

Fishing

Rock Wall

Horses

Kitchen

First Aid

Co-operative Games

Obstacle Course

Grounds

Check-In

Photography

Sensory Area

Planning Committee

Visitor

Other

2nd Volunteer Choice(Required)

Please check ONLY ONE box for your second choice of volunteer position

Group Leader

Assistant Group Leader

Provided Buddy

Crafts

Fishing

Rock Wall

Horses

Kitchen

First Aid

Co-operative Games

Obstacle Course

Grounds

Check-In

Photography

Sensory Area

Planning Committee

Visitor

Other

Provided Buddy

If you are a family provided buddy, please list the name of the camper that you will be a buddy for.

Buddy Relationship

If you are a family provided buddy, what is your relationship to the camper?

Parent

Grandparent

Nurse

Therapist

Friend

Other

Comments

Do you have any additional information that might be helpful?

Permission to Participate

I authorize Team Up With Families to conduct research on my background in order to approve my volunteer/visitor application and to ensure the safety of the camp environment. I understand Team Up With Families may refuse my application if such investigations reveal matters that may indicate my unsuitability as a volunteer, at the sole discretion of Team Up With Families.

Many of the wonderful camp experiences are photographed by family members and volunteers, along with occasional visits from local media. Your image or likeness (photographs, films, videotapes, electronic recording) may be used for publicity or publications to spread the word about Team Up! With Families and Team Up for Fun! Day Camp or to thank sponsors and volunteers.

Disclosure of Risk

As a volunteer/visitor at the Team Up for Fun! Day Camp, and in recognition of the possible danger to which I may be voluntarily subjected to, including, but not limited to, fishing, horseback riding, hiking, adapted sports, and cooperative games, the undersigned hereby knowingly, freely and voluntarily waive any right or cause of action, of any kind whatsoever, arising as a result of such activity from which any liability may or could occur as a volunteer at the Team Up for Fun! Day Camp to be held July 22-25, 2024.

I understand that safety measures will be taken and CDC guidelines will be followed in reference to COVID-19. Vaccinations are not required but are highly recommended.

Acknowledgement

I understand that reasonable measures will be taken to safeguard the health and safety of all volunteers and visitors, and that parents of minor children will be notified as soon as possible in case of any emergency. If an emergency were to happen, I understand that I will be taken to the nearest hospital. In the event that a parent of a minor child cannot be reached in an emergency, I hereby authorize the calling of a physician at my expense to provide whatever medical or surgical treatment is necessary.

It is expressly understood and agreed that Team Up! with Families, Inc., , as well as their board members and volunteers, or any other participating organization shall not be responsible or legally liable for any losses of personal property or for any bodily injuries, or the results thereof, incurred and suffered by my child in connection with any activities or programs associated with “Team Up for Fun!” Day Camp.

Acceptance of Terms(Required)

I am 18 years of age or older and have read and agree to the terms described above in permission, disclosure and acknowledgement.

I am under 18 years of age and I need Bridget to e-mail me the terms to be signed by a parent and returned.

Confirmation If you do not receive confirmation from Bridget either via e-mail or US mail within 2 weeks of your submission, please contact her directly.

Deadline Please submit this form ASAP. If you have any questions please contact Bridget at (262) 490-8183 or teamupforfuncamp@gmail.com

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IMPORTANT LINKS

CONTACT INFORMATION

Team Up With Families - Katy's Kloset
404 Wilmont Dr D,
Waukesha, WI 53189
262-746-9034