TEEN MENTOR APPLICATION
Mentor Name
Your answer
Birth Date
Your answer
Age
Your answer
Name/Year in School (Fall 2017)
Priority will be given to 10th, 11th and 12th grade students. Entering freshman may still apply.
Your answer
Year of Graduation
Your answer
Mentor Email
Your answer
Mentor Cell Phone Number
Your answer
Home Phone Number
Your answer
Parent Name
(First, Last)
Your answer
Parent Email
Your answer
Parent Cell Phone Number
Your answer
Home Street Address
Your answer
City
Your answer
State
Your answer
Zip Code
Your answer
Preferred Track & Weeks of Camp
Sessions begin June 19 through the end of the week of August 7.
We will be giving priority for applicants who can work for 2 weeks.
If you want to volunteer for the week beginning June 19, but are also available for the weeks of July 10 and 17th, write 06/16 under 1st Choice, 07/10 under 2nd Choice, and 07/17 under 3rd Choice.
First Choice (between June 19 - August 7)
Your answer
Second Choice (between June 19 - August 7)
Your answer
Third Choice (between June 19 - August 7)
Your answer
How many weeks are you able to participate:
Preferred Track (if available)
References: All Applicants
SummerAde Staff would like to hear from both of your listed references.
Please ask both of your references complete the SummerAde Teen Mentor Reference Form. (Located next to the Teen Mentor Application Form on the Apply Now button)
Reference #1
Please include reference's first and last name, their phone number, email and their relationship to camper
Your answer
Reference #2
Please include reference's first and last name, their phone number, email and their relationship to camper
Your answer
Training Dates & Location
Please choose one of the following Training Dates. All trainings will be held at Social Learning Works: 500 Tamal Plaza, Suite 529 Corte Madera, CA 94925
Goals for volunteering for SummerAde
Please choose 2 goals that you have in working with SummerAde
Required
Please tell us why you want to participate in SummerAde. Include your past experiences working with children.
100+ words
Your answer
How did you hear about us?
Your answer
PARENT WAIVER FORM & PHOTO CONSENT: Please read and check the box below.
As parent and/or legal guardian and representative of Teen Mentor, I agree to abide by the rules of the camp for the health, safety and welfare of all campers. I authorize my Teen Mentor to assist and accompany a SummerAde camper in all camp activities. I acknowledge that certain activities have an inherent risk of injury, and agree to assume the risk of injury associated with my Teen Mentor’s participation in such activities. I release, indemnify and hold harmless, the SummerAde program, associated representatives and sponsors from and against any injury, claims, damages, liabilities, costs and expenses, including attorney fees, allegedly sustained or incurred by, or asserted on behalf of, either (i) my Teen Mentor or (ii) any other registered camper, that are attributable to, or a result of, my Teen Mentor’s participation or conduct in activities while attending camp. SummerAde reserves the right to terminate the engagement of your Teen Mentor to provide assistance to a camper and attendance at camp, if your Teen Mentor’s behavior or conduct, in the sole and best judgment and discretion of SummerAde, is unsatisfactory or otherwise determined to be detrimental to camper and/or other campers. I acknowledge that I have consulted with my attorney or other advisors to the extent I deem appropriate to evaluate this release and indemnity, and that I have not relied upon SummerAde for such advice.
Required
SummerAde relies on your donations
Please visit the Donate page on our website so that we may continue to offer this program free of charge.
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