iCan Swim Volunteer Registration Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Host name: Coastal Bringing Up Down Syndrome of Southeastern NC
Camp dates: June 12, 2023 - June 16, 2023
Camp location/address: Brunswick Community College Aquatics and Fitness Center, 50 College Rd NE Bolivia NC 28422

We are pleased to offer this swim program to people with disabilities and look forward to having you play an important part in helping our swimmers reach their goals in the aquatic environment.

***NO PRIOR EXPERIENCE WORKING WITH PEOPLE WITH DISABILITIES IS NECESSARY***

AGE REQUIREMENT: Volunteers must be at least 15 years old.
If you are under 15, please contact the Camp Host for possible opportunities.
SKILL REQUIREMENT: Volunteers must be comfortable in the water

For questions please contact For questions please contact Jessica Wilson aticanswimbrunswickco@gmail.com

Volunteer First Name *

Volunteer Last Name *

Age at START OF CAMP *

T-shirt size

XXL

Clear selection

E-mail address *

Please ensure you have entered a valid email. The Camp Host will use this address when corresponding with you.

Cell Phone *

Please enter 10 digits

Home Address (Number and Street) *

Home Address (City) *

Home Address (Zip Code) *

5 digits only, please

Home Address State/Province *

Emergency Contact Name *

Emergency Contact Phone *

Please enter 10 digits

Parent/Guardian Email (if volunteer is under 18 y/o)

Please ensure you have entered a valid email. The Camp Host will use this address when corresponding with you.

Clear form

Never submit passwords through Google Forms.

This form was created inside of iCanShine. Report Abuse

Forms