Adult Volunteer Application and Agreement for Highlander District Day Camp 2019
Adults from Cub Scouting, Boy Scouting and Venturing, and sponsoring church register here to volunteer at Highlander District Day Camp June 17 - 21, 2019 at St Elizabeth Ann Seton Catholic Church, 1000 Andrews Rd, Fayetteville, NC 28311.
Email address *
Passport to Adventure
First and Last Name *
Your answer
BSA ID Number (if none, write none) *
Your answer
I am registered as a leader in the following Scouting Program *
Unit *
Your answer
Current Scouting Position (parent, den leader, committee member, etc.) *
Your answer
Youth Protection training date *
Your answer
Driver's License Number and State *
Your answer
BSA Annual Health and Medical Record (AHMR) part A & B is required for scouting events 72 hours or less. This form is good for one year. List the date of your current of your current BSA AHMR part A & B and please turn in a copy of this form to camp with a copy of your insurance card attached. *
Your answer
First Aid/CPR/AED training date if certified and name of certifying agency (Red Cross, American Heart Association, etc.)
Your answer
Additional BSA Training
Your answer
Date of Weather Hazards training.
Phone Number *
Your answer
Mailing Address *
Your answer
T-shirt size - *
Days Available to Volunteer *
All Day 7:30-16:30
Morning only 7:30-12:00
Afternoon only 12:00-16:30
Not Available
Saturday June 15 for set up
Monday June 17
Tuesday June 18
Wednesday June 19
Thursday June 20
Friday June 21
Row 7
How would you like to volunteer for day camp? *
Please list any medical conditions or physical characteristics camp staff must be aware of: *
Your answer
Uniform Requirements
1. Staff (Youth and Adult): camp t-shirt, pants and closed toed shoes.
2. Volunteer Adult: name tag, camp arm band, shirt, pants and closed toe shoes
3. Youth volunteer: camp t-shirt, pants and closed-toe shoes
Note: Camp t shirt is for 5 day volunteers only. Camp will loan you a reflective vest to wear over your own scouting t shirt while volunteering.
Media Release
I hereby assign and grant to Highlander Day Camp, Occoneechee Council, and the Boy Scouts of America the right and permission to use and publish the photographs/film/videotapes/electronic representations and/or sound recordings made of me or my child at all Scouting activities, and I hereby release the Boy Scouts of America, the local council, the activity coordinators, and all employees, volunteers, related parties, or other organizations associated with the activity from any and all liability from such use and publication. I hereby authorize the reproduction, sale, copyright, exhibit, broadcast, electronic storage, and/or distribution of said photographs/film/videotapes/electronic representations and/or sound recordings without limitation at the discretion of the Boy Scouts of America, and I specifically waive any right to any compensation I may have for any of the foregoing.
Media Release Agreement *
Occoneechee Council BSA Volunteer Agreement
(To be filled out in conjunction with staff/volunteer application and BSA Medical Form)

Upon signing this Agreement. . .

 I understand this a Staff/Volunteer Position offering no monetary compensation.
 I believe my attitude toward volunteer work should be professional.
 I believe that I have an obligation to my work, to those who direct it, to my colleagues, and to the Cub Scouts.
 I will seek to be fair and consistent with the Scouts.
 I understand that there will be no abusive language tolerated by anyone at camp.
 No smoking is allowed in camp.
 I understand alcohol and drug use is strictly forbidden.
 I understand that firearms are strictly prohibited (except those approved by the BB range master).
 I will not submit the Scouts or staff/volunteers to any form of initiations.
 I will be neatly groomed, and wear appropriate clothing. Closed-toed shoes are required, no sandals.
 I will follow the guidelines presented in the Day Camp Staff information booklet; and will assist, to the best of my ability, in Day Camp operations.
 I will keep confidential matters confidential.
 I will promote a pleasant attitude and will strive to see that each scout has a positive Day Camp experience.
 I understand that failure to adhere to this agreement could be cause for dismissal by the Day Camp Director.
 I will not leave camp without notifying the Camp Director or the Business Director.

To finalize your volunteer registration process, fill out the forms below:
The information from this form will be used to create an application and agreement form for you to sign.

Please bring a copy of your BSA Health and Medical form part A & B to camp (no doctor visit needed).
If you need this form go to
Volunteers who have taken Youth Protection, please bring a copy of your certificate. You may take the course at if you have not already done this easy online course that is required.

If you have any questions, please contact the camp director at or 910-213-6726.
Your answer
Thank you for volunteering for 2019 Day Camp.
If you have any questions, please contact the camp director at or 910-213-6726.
Please mail BSA Health and Medical Form Part A & B, youth protection certificate, and First Aid/CPR/AED training certificate (if certified) to Michelle Sweeney 6116 Garden Court, Fayetteville, NC 28311.
or turn in at Round Table OR Parent Orientation Meeting
(dates listed at
A copy of your responses will be emailed to the address you provided.
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