Camp Circle Star Volunteer Application
Volunteers must be age 16 or over
Email address *
Name First Last *
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Address City State Zip *
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Cell Number *
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T Shirt Size *
Date of Birth *
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Referred By:
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In case of emergency, please contact, Phone *
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High School, Dates Attended, Degrees
Your answer
College/University, Dates Attended, Degrees
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Have you worked with people with disabilities before? *
If yes, please briefly describe your experience.
Your answer
We provide transportation from the Sam’s Club at 13455 Manchester Rd, 63131. We meet at 8am and return at 4pm. You may park your car there for the day. Will you be using our transportation? *
Do you have a history of drug or alcohol abuse? *
Do you have knowledge of any condition (back, knees, other) which wouldprevent you from lifting/carrying 40 lbs.? *
Have you ever been charged or convicted of physical or sexual abuse or neglect? *
Do you have any physical or cognitive challenges that may limit your performance in the volunteer position you are applying for? *
If so, what can be done to support you?
Your answer
I would like to volunteer the following dates (check all you are interested in): (*) Indicates Single Day Camps, aka “Fun Days” Summer camps are Monday-Friday, 8am-4pm, including transportation time. Volunteers must be available for the entire week to ensure continuity for the campers. *
Required
I hereby certify that the answers given by me to the questions and statements above are true and correct, without reservations of any kind whatsoever, and that no attempt has been made by me to conceal pertinent information. (Signature & Date) *
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