Safety Town Around Town HS Volunteer
Safety Town Around Town will take place June 24-27 at Sunny Hill Elementary School in Carpentersville, from noon-3pm. Campers and Volunteers will travel by bus to and from the Safety Town permanent site on Thursday, June 27.
Email address *
Volunteer Name *
Your answer
Volunteer email address *
Your answer
Volunteer's phone number *
Your answer
Volunteer's Parent Name *
Your answer
Volunteer's parent email address *
Your answer
Volunteer's Parent Phone number *
Your answer
In case of emergency and parent cannot be reached, please contact *
Your answer
Volunteer's grade and school for 2019-20 *
Your answer
I am fluent in Spanish *
Have you been a Safety Town volunteer before? If so, when? *
Your answer
What is your adult shirt size? *
Do you have any special needs that we should be aware of? Please explain *
Your answer
Do you have any allergies that we should be aware of? Please explain and provide treatment plan *
Your answer
May we text you with reminders about Safety Town? *
Code of Conduct
As a Safety Town Volunteer, I agree to abide by the following code of conduct. ● Set a good example for the campers. ● Act responsibly and to ensure my safety and the safety of the campers around me. ● To use appropriate language. ● To speak respectfully to the campers, the leaders and my fellow volunteers. ● Dress in an appropriate way. Volunteers are expected to wear the green volunteer shirt provided to them with walking shorts preferably in black, blue or khaki. Additionally, I agree not to “personalize” my shirt until after Safety Town is over. Personalizing includes not cutting, ripping, removing sleeves, etc. Volunteers are asked to also wear closed toe shoes (gym shoes) during Safety Town. ● I agree to arrive on time and to communicate any changes in the schedule to my parents/guardians to ensure they pick me up on time. ● By signing up to volunteer, I agree to attend every day unless I am ill or I have made arrangements with the Site Director in advance. ● I agree to not use my cell phone to text or call friends during the Safety Town session. I wish to register as a Safety Town Volunteer and agree to abide by the Safety Town Volunteer Code of Conduct. *
Parent Permission
I agree to support my child’s participation and to ensure they abide by the Code of Conduct. *
I give permission for my child to travel by school bus from Sunny Hill Elementary School to the BJWC Safety Town site, 1301 Orchard, Barrington on June 27, 2019 *
In consideration for my child's participation in Safety Town 2018, the undersigned hereby releases BJWC, its representatives, employees, members, executives, sponsors and volunteers, from any and all claims, known or unknown, of liability, costs and damages which may arise from my child's participation in Safety Town activities. I agree that my child has my consent to participate in all Safety Town activities. I further provide my consent for BJWC, its representatives, employees and volunteers to seek emergency treatment for my child if necessary. I agree to accept financial responsibility for the costs related to said emergency treatment. The provisions of this Waiver and Release from Liability are governed by the laws of the state of Illinois. By checking YES, the signer acknowledges that he or she is at least 18 years old, is the parent or legal guardian of the child for whom this registration pertains, has read this Waiver and Release from Liability in its entirety and agrees to all terms within. *
A copy of your responses will be emailed to the address you provided.
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