"The Art of Being Social" Summer Camp Volunteer Application - 2017
Please complete the following application.
Full Name *
Your answer
Email *
Your answer
School or Work *
Your answer
Age *
Your answer
Home Address *
Your answer
If you are at least 18 years of age, you must get a background check. Please check that you understand that and will get it done prior to camp and have results sent to Melodic Connections.
Phone Number *
Your answer
Please indicate which camp dates and locations you are available to volunteer: (We prefer a commitment of at least one full week.) *
Required
Camp hours are 9:00 am - 3:00 pm, Monday through Friday. Volunteers should arrive at 8:30 on the Monday of their camp week for a brief orientation *
Required
T-Shirt Size (we cannot guarantee volunteers will receive t-shirts at this time)
We want to know about you! What are your interests/hobbies? *
Your answer
What do you hope to gain from volunteering? (future career knowledge, helping children, volunteer hours, learning about music, etc.) *
Your answer
Please provide the name, email and phone number of at least one non-family member who can serve as a reference: *
Your answer
Waiver and Release *
As a volunteer for Melodic Connections Incorporated (“MC”), I agree to abide by all applicable rules and regulations of MC and the Ohio Division of Developmental Disabilities. I understand that I will receive no monetary or other benefits in return for my volunteer service and that MC may terminate this agreement at any time without prior notice for any reason. I hereby authorize MC to check my references and I understand that a criminal background check is required if I am at least 18 years of age. I certify that my answers on this application are true and complete and that I have not knowingly withheld information that might, if disclosed, be viewed negatively by MC. I understand that any misrepresentation or omission of facts on this application could be cause for rejection of this application or dismissal. I understand that after I submit my application, it will be reviewed and my eligibility for volunteer work will be determined by MC in its sole discretion. I understand that an interview may be requested. I understand I must attend a training session on the Monday of the first week of camp for which I volunteer. RELEASE I hereby release and forever discharge and hold harmless MC, its directors, officers, employees and agents, camp location partners and its successors and assigns, in each case from any and all liability, claims, and demands of whatever kind or nature, either in law or in equity, which arise or may hereafter arise from the services I perform for MC. Further, I agree that MC and its camp location partners are not liable for any damage to my property or my dependent's property resulting from volunteer work for MC. I further agree to defend, indemnify and hold harmless MC and its camp partners. I understand and acknowledge that this release discharges MC from any liability or claim that I may have against MC with respect to bodily injury, personal injury, illness, death, or property damage that may result from the services I provide to MC or occurring while I am providing volunteer services. I agree that this release is as broad and inclusive as permitted by the laws of the State of Ohio. I agree that I am responsible for my own insurance coverage in the event of personal injury or illness that results in any way from my volunteer work. I understand that MC does not assume any responsibility for or obligation to provide me with financial or other assistance, including but not limited to medical, health or disability benefits or insurance of any nature in the event of my injury, illness, death or damage to my property. I expressly waive any such claim for compensation or liability on the part of MC. CONFIDENTIALITY While preforming volunteer tasks, I may learn personal information about participants. During and after my performance of services for MC, I will maintain participant confidentiality and shall keep confidential all information relating to sensitive situations within MC, except as demanded by law or to prevent a clear and immediate danger to one or more person. I also hereby agree to maintain confidentiality by refraining from posting MC-related content on social network sites (Internet, Facebook, Twitter, YouTube, Vine, etc.) and to not use photos or likenesses of participants, in each case without prior written consent of MC. PHOTO RELEASE I consent to and authorize the use and reproduction by MC of any and all photographs and any other audio-visual materials taken of me for promotional material, educational activities, and exhibitions or for any use benefitting MC. I grant and convey to MC all right, title, and interests in any and all photographs, images, video, or audio recordings of me or my likeness or voice made by MC in connection with my providing volunteer services to MC. WAIVER By signing this waiver, I expressly authorize MC and its employees to furnish any prospective employer, educational institution or anyone to whom you direct us to provide information regarding my volunteer service with MC including, but not limited to, my work record and job performance.
Required
Signed by applicant if over 18, or by parent if under 18 *
Your answer
By entering my electronic signature above, I affirm that I have read and agree with the terms and condition of this agreement. *
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