Kind Camp Middle School Volunteers

(Middle School Student) Volunteer Name*

First Last

Parent/Guardian Name*

First Last

Phone*

Parent or Guardian Email*

Parent or Guardian Signature*

Grade Volunteer Just Finished*

Name of School*

Are there any special circumstances or anything you would like to share to help us better serve your child at Keys To Kindness, Kind Camp?*

Does your child have any allergies or other health or medical concerns we should be aware of?*

If yes, please describe*

How did you hear about us?*

What makes you a good candidate to volunteer at Kind Camp?*

What are your greatest strengths? How do they help you as a volunteer?*

Have you had CPR Training within the past year?*

Please complete in the box below. Have you worked with Elementary School children before? If so, what type of work? If no, please write NA in the box below.*

Billing Information

Cost Per Session: $50.00, Includes Lunch for Friday only. Due at time of registration (non-refundable) $35.00 Kind Camp Shirt. Please pack a water bottle, sunscreen, and lunch with no peanuts or peanut items. Please complete the Emergency & Authorization Form & Photo Release Form as well. All forms must be completed. Payment is due upon registration. Thank you kindly!

Address*

Street Address Address Line 2 City State ZIP Code

Choose Your Camp(s)*

Week 1 / June 17- June 21, 2024
Week 2 / June 24 - June 28, 2024

Shirt Size*

Required Shirt Fee (first t-shirt)

Price: $35.00

Additional T-Shirts

Price: $35.00

Credit Card*

Card Details

Cardholder Name

Processing Fee

Price: $0.00

Total

$0.00

Certification of accurate information.*

I agree

Certification of accurate information:* I certify that all answers or statements I have made on this application or other supplementary materials are true and correct without omissions. I acknowledge that any false statements or misrepresentations on this application or other supplemental material, not abiding by rules, regulations, and policies, will be cause for dismissal from volunteering with Keys To Kindness. I understand that I will be volunteering at my own risk and that the organization, its employees and affiliates, cannot assume any responsibility for any liability for any accident, injury, or health problem which may arise from any volunteer work I perform for the organization. I agree that all the work I do is on a volunteer basis and I am not eligible to receive any monetary payment or reward.

Signature*

Billing Information

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