2019 Team Up Camp Volunteer Registration
Held at Harnischfeger Park- A Dodge County Park in Ixonia, WI July 22-25, 2019
First Name *
Your answer
Last Name *
Your answer
Name as you would like it to appear on your nametag *
Your answer
Gender *
Required
Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Phone Number *
Your answer
Age *
Volunteers age 13 or under need to contact Bridget Bruno for available opportunities
Your answer
Birthdate *
Your answer
Parent's Name
If under the age of 18
Your answer
Parent's Phone Number
If under the age of 18
Your answer
e-mail address *
Your answer
E-mail Confirmation
Would you like confirmation via e-mail?
Emergency Contact *
Please list your emergency contact Name AND Phone Number.
Your answer
Physician *
Please list your primary care physician's name AND phone number.
Your answer
Allergies *
Please check ALL that apply.
Required
Allergens
If checked above, please list any specific allergies, and the type of reaction
Your answer
Life Threatening *
Are any of these allergies life threatening?
Required
Background *
Have you ever been convicted of a felony?
Required
Background Explain
If yes, please explain.
Your answer
T-Shirt Size *
Required
Days *
Which days are you available to help at camp?
Required
Child's Activity *
If your child is a camper, would you like to be scheduled around his/her activities?
Required
List
If yes, which activities (ex. rockwall, fishing, lunch, etc.)
Your answer
How did you hear about camp? *
Your answer
Experience *
Please list any experience working with children with special needs.
Your answer
CPR *
Do you have current CPR or First Aid training?
Required
Volunteer Opportunities-ALL 4 DAYS REQUIRED!!!
-Group Leader –age 18+ You are responsible for a group of up to 13 campers. You will be working together with parents, buddies and activity leaders to provide a quality camp experience. Group Leaders must be at camp all 4 days.

-Assistant Group Leader-age 15+ – You are responsible for assisting the group leader. This would be a good opportunity to train for a group leader position in the future.

-Provided Buddy - A family has requested yo to be their child's buddy at camp. You will be helping them participate in group activities to the best of their ability. You would be responsible for assisting campers with activities and helping to get them around the camp environment.

Additional Volunteer Opportunities-Flexible Days
-Crafts-age 13+ - You would be leading and helping the groups during craft projects, and helping with set up and clean up.
-Fishing-age 14+
-Rock Wall-age 15+ You would be responsible for helping campers get set up for climbing, assisting with harnesses and helmets. (Tues. and Thurs. only)
-Horses-age 14+ Would like volunteers to have horse experience, responsible for assisting campers, side walking, etc.
-Kitchen-age 14+ - This would involve serving snacks and lunch to campers and volunteers, also set up and clean up.
-First Aid- This would involve administering medications, changing diapers, assisting with G-tube feedings, and tending to minor injuries that occur on the camp grounds.
-Co-Operative Games-Assist activity leader with various games and activities while working with each group as a cooperative team.
-Obstacle Course-Assist physical therapist with a theme related obstacle course.
-Grounds-age 25+ Help with transporting campers to and from activities, filling water coolers, collecting garbage, etc.
-Check-In- Need help Monday morning (8:30-10:00) checking in campers and volunteers
-Photography- age 14+ - Take group pictures and various pictures of activities at camp.
-Sensory Area-age 18+ You will be assisting campers who are having difficulty staying with the group. There will be a variety of options at this station.
1st Volunteer Choice *
Please check ONLY ONE box for your first choice of volunteer position
Required
2nd Volunteer Choice *
Please check ONLY ONE box for your second choice of volunteer position
Required
Provided Buddy
-If you are a family provided buddy, please list the name of the camper that you will be a buddy for.
Your answer
Buddy Relationship
-If you are a family provided buddy, what is your relationship to the camper?
Comments
-Do you have any additional information that might be helpful?
Your answer
Permission to Participate
I authorize Team Up With Families to conduct research on my background in order to approve my volunteer/visitor application and to ensure the safety of the camp environment. I understand Team Up With Families may refuse my application if such investigations reveal matters that may indicate my unsuitability as a volunteer, at the sole discretion of Team Up With Families.

Many of the wonderful camp experiences are photographed by family members and volunteers, along with occasional visits from local media. Your image or likeness (photographs, films, videotapes, electronic recording) may be used for publicity or publications to spread the word about Team Up! With Families and Team Up for Fun! Day Camp or to thank sponsors and volunteers.

Disclosure of Risk
As a volunteer/visitor at the Team Up for Fun! Day Camp, and in recognition of the possible danger to which I may be voluntarily subjected to, including, but not limited to, fishing, horseback riding, hiking, adapted sports, and cooperative games, the undersigned hereby knowingly, freely and voluntarily waive any right or cause of action, of any kind whatsoever, arising as a result of such activity from which any liability may or could occur as a volunteer at the Team Up for Fun! Day Camp to be held July 22-25, 2019
Acknowledgement
I understand that reasonable measures will be taken to safeguard the health and safety of all volunteers and visitors, and that parents of minor children will be notified as soon as possible in case of any emergency. If an emergency were to happen, I understand that I will be taken to the nearest hospital. In the event that a parent of a minor child cannot be reached in an emergency, I hereby authorize the calling of a physician at my expense to provide whatever medical or surgical treatment is necessary.

It is expressly understood and agreed that Team Up! with Families, Inc., , as well as their board members and volunteers, or any other participating organization shall not be responsible or legally liable for any losses of personal property or for any bodily injuries, or the results thereof, incurred and suffered by my child in connection with any activities or programs associated with “Team Up for Fun!” Day Camp.

Acceptance of Terms *
Required
Deadline
Please submit this form ASAP. If you have any questions please contact Bridget at (262) 567-7807 or brunobunch@att.net
Confirmation
If you do not receive confirmation from Bridget either via e-mail or US mail within 2 weeks of your submission, please contact her directly.
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