Old Application Form
If you want to apply to be a Volunteer on one of our five weeks of Summer Camp you need to complete this form giving information about yourself. We will require you to commit to attend the whole week you are applying for.

Please complete this form accurately and with care. Information you give in Sections 1, 2, 3 and 4 will be passed on to the Camp Leader to assist them with the organisation of their week of camp. If possible they will match your interests with the jobs available on camp.

Registered charity 510785 Form issue 0.1

Should you have any questions regarding the completion of this form please email us at: leanebailey92@gmail.com

Section One - All applicants
Previous Camps *
Have you helped on one of our camps before? New Helpers are warmly welcomed to our group.
Member of our Group
If you have helped DKC previously - we would like to know how many YEARS you have been involved in the group?
Your answer
Your Personal details
Information in this section will remain confidential within the Volunteer Selection Team
Title *
Mr/Mrs/Miss/Ms/Dr/MP/PC etc (Please state)
Your answer
Surname *
Your answer
Fornames *
Your answer
Address 1 *
House name / number and street.
Your answer
Address 2
District.
Your answer
Address 3 *
Town.
Your answer
Address 4 *
County.
Your answer
Post Code *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Home Phone Number
please include area code if this is a landline. Please include one space after the fifth digit of this number.
Your answer
Mobile Phone Number
please include one space after the fifth digit of this number.
Your answer
Work Phone Number
please include area code if this is a landline. Please include one space after the fifth digit of this number.
Your answer
Your e-mail address *
please enter carefully - we will use this in our address book to contact you.
Your answer
Occupation
Your answer
Your Employer
this may help us when applying for grants.
Your answer
Your Ethnic Origin
this will only be used for our monitoring purposes.
Your answer
Contact method *
The best way to keep in contact with me is via:
E-mail
Phone
Mobile
Text
Facebook
Health or Diet *
Details of any health problems or dietary needs that may be relevant to your voluntary work? or type NONE
Your answer
Section Two - All applicants
Emergency Contact Details:
Please give details of someone we would be able to contact in the case of an emergency on camp. Please make sure they are available whilst you are on your week of camp !
Emergency contact Full Name *
Your answer
Emergency contact Address *
please give their full address
Your answer
Emergency contact Post Code
Your answer
Relationship to you *
Your answer
Emergency contact Main Phone Number *
please include area code if this is a landline. Please include one space after the fifth digit of this number.
Your answer
Emergency contact Alternative Phone Number
please include area code if this is a landline. Please include one space after the fifth digit of this number.
Your answer
Section Three - All Applicants
Availability for Summer Camp:

Please tick the week you are available to help on camp. It is important to include a second choice if possible as this could help to ensure that all weeks are adequately staffed.

Select your Week
Please indicate your two preferences for your week of camp. If you wish to help on MORE than one week of Summer Camp, please identify this in the third line '2nd Week'. (Please note that you cannot help on two consecutive weeks)
Week 1 - 29th July to 5th Aug. (Liam)
Week 2 - 5th Aug to 12th Aug. (Lizzy)
Week 3 - 12th Aug to 19th Aug. (Helen)
Week 4 - 19th Aug. to 26th Aug. (Harriet)
Week 5 - 26th Aug. to 2nd Sep. (Cat)
1st choice
2nd choice
2nd Week
Help us to Build Camp *
The build-up and take-down of camp, the tents, marquees and equipment requires a considerable amount of hard work and people to ensure everything is completed in a very short period of time. We now ask all our volunteers to help out with at least one day of building or taking down of Camp. Please tick one (or more) of these activities which you are able to assist with. Camp Build and Take-down will be at our camp site:
Yes
No
Camp Build - 27th July, lunchtime onwards
Camp Build - 28th July, all day
Camp Build - 29th July, morning only
Camp takedown - 2nd Sept, lunchtime onwards
Camp takedown - 2rd Sept, all day
Section Four - All Applicants
Your Interests & Skills:
Note: None of the experience, skills or abilities mentioned in this section are essential for Camp Helpers. However, it is important to complete this section to assist our Camp Leaders in planning their weeks and that we can use your skills during your week of camp.
Experience with children
Please give details of any experience you have in working with children:
Your answer
Swimming Pool *
Are you able to go into the swimming pool to supervise and join in with the activity ?
Yes
No
Night Rota *
Are you able to assist in a Night rota? Night rotas are important for the safety and security of the children on camp. This rota requires two teams of at least two different staff to be awake on duty, for half of the night. Staff will be given time to catch up on sleep. Rotas will be chosen fairly from volunteers. Volunteers under the age of 18 years are excused of this task. Thanks for your help in this area.
Yes
No
Reason
If there is any reason you feel you cannot be involved in a night rota please specify.
Your answer
Cooking on camp *
Are you willing to cook on camp ?
Yes
No
First Aid Qualified
Please give details of any first aid qualifications you have? Proof of any First Aid qualifications will need to be shown to your Camp Leader prior to your week of camp.
Your answer
Car on camp *
Will you have a car on camp ?
Yes
No
Car Insurance *
if YES, is your car insured for business use ?
Yes
No
Minibus Drivers *
Have you any experience of driving a minibus ? If YES an additional Minibus Form will be sent to you for completion.
Yes
No
Minibus Licence
If you are offering to drive a minibus for us - does your Driving Licence include clause D1 (minibus)
Yes
No
Activity skills
There are many jobs to do on your week of camp. This will help your Camp Leader make their selection in choosing the helpers to carry out these tasks for your week. Don't worry if you are a new helper this year - there are instructions how to do each job - and there will be so many other people who will help you.
Yes
Hill Walking
Outdoor Sports
Indoor Activities
Crafts
Camp Songs
Equipment maintenance
Other skills
Please tell us about any other of your skills or interests that you feel may be useful on camp.
Your answer
Other help you could offer the group
To successfully run five weeks of summer camp it requires lots of preparation throughout the year. Are you willing to offer help in any of the following areas? If you cannot commit yourself to regular attendance, even occasional assistance would be invaluable to us.
Yes
I could help a bit
Fundraising team
Equipment team
Camp Organisation team
Section Five - New Applicants Only
If you have not been on any Derby Kid’s Camp holidays before, you MUST complete this section.

Please provide details on an independent referee who can vouch for your character and attitude to children. (This should be a teacher, youth leader, minister, employer, or someone similar, but NOT someone who is a relative, friend or Derby Kids’ Camp member).

Please ensure that your referee is willing and available to supply a reference before completing this section. No new volunteers can be accepted without references.

1st Ref. Full Name
please give details of your 1st Referee
Your answer
1st Ref. Address
please give their full address
Your answer
1st Ref. Post Code
Your answer
1st Ref.Telephone
please include area code if this is a landline. Please include one space after the fifth digit of this number.
Your answer
1st Ref. E-mail address
please enter carefully
Your answer
2nd Ref. Full Name
please give details of your 2nd Referee. This can help speed up the application process.
Your answer
2nd Ref. Address
please give their full address
Your answer
2nd Ref. Post Code
Your answer
2nd Ref. Telephone
please include area code if this is a landline. Please include one space after the fifth digit of this number.
Your answer
2nd Ref. E-mail address
please enter carefully
Your answer
How did you hear about our group ?
In the interests of improving our profile and attracting new volunteers, could you please detail how you heard about Derby Kids’ Camp ?
Other source
or was it another source - please give details - or who introduced you to our Group ?
Your answer
Section Six - All Applicants
TRAINING

Attending the Volunteer Training Day is considered to be essential for all new volunteers. We will explain how camp works, how we help the children to have a good holiday, what you need to bring with you, etc.

Experienced volunteers are also recommended to attend.

This year's Training Day will be held on SUNDAY 26th JUNE at Rolls Royce Leisure Nightingale Room (Start times to be confirmed).

I will be attend Volunteer Training Day. *
Yes
No
New Volunteer - Cannot attend
If you are a New Applicant and believe there are exceptional circumstances why you are unavailable to attend Training Day, please explain here:
Your answer
Section Seven - All Applicants -- DECLARATION --
Information given in this section will remain confidential to the Volunteer selection team.
Other Voluntary Groups *
HAVE YOU BEEN INVOLVED WITH ANY OTHER VOLUNTARY GROUPS IN THE LAST FIVE YEARS? (Please give details including a contact phone number). If not enter NONE.
Your answer
DISMISSED or SUSPENDED *
HAVE YOU EVER BEEN ASKED TO LEAVE, BEEN DISMISSED / SUSPENDED FROM VOLUNTARY OR PAID EMPLOYMENT WITH CHILDREN? (Please give details including a contact phone number). If not enter NO
Your answer
Formal Agreement *
I AGREE TO THE ABOVE STATEMENT, AND THAT ALL OTHER INFORMATION I HAVE GIVEN IN THIS FORM IS TRUE AND ACCURATE, AND I WILL ABIDE BY THE GROUP’S CONSTITUTION. A copy of the Derby Kids’ Camp Constitution is available on the web site www.derbykidscamp.co.uk
WE RESERVE THE RIGHT TO MAKE FURTHER ENQUIRIES IF WE FEEL IT NECESSARY.

I understand that in the instance of an assault on or harassment of another person, (eg. physical, sexual or verbal), I will be asked to leave the Group (camp) immediately. Derby Kids’ Camp will not be responsible for defending me should criminal proceedings ensue.

Photo of Yourself *
We need to have a current photograph (passport style) of yourself. This will be going on your ID badge for camp. So please take a good photo of your self against a plain background (not the normal selfie). Please e-mail this together with your full name to: leanebailey92@gmail.com
IF YOU NEED A DBS CHECK THIS YEAR YOU WILL BE CONTACTED BY YOUR CAMP LEADER TO ARRANGE THIS.

PLEASE NOTE: unfortunately we cannot automatically guarantee you place on Summer Camp purely on receipt of your Application Form. All applicants need to be processed and your place on Camp will only be confirmed when you are contacted by a Camp Leader. Your application will also be subject to a satisfactory DBS check being processed prior to Camp. We would appreciate a a voluntary contribution of £6 towards the cost of the DBS check.

THANK YOU FOR COMPLETING THIS VOLUNTEER APPLICATION FORM.

By pressing the blue SUBMIT tab, this form will be sent directly to our Volunteer Office.

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