Camp Volunteer Application

Thank you for your interest in volunteering at Hickory Hill Farm's Day Camp! Please read the following description of a staff member position at Hickory Hill Farm's Day Camp for which you are applying for:
Staff members are responsible to supervise and counsel up to 10 campers per week (ages 7-13) and engage in camp programs wherever needed. Counseling responsi-bilities occur during the day and members will provide a fun and supportive envi-ronment that promotes creativity and personal growth.
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    Background Information

    At Hickory Hill Farm, we request the following information because of our dedication to our campers and their families. This section is confidential and is required by Hickory Hill Farm. It is required by our safety regulations and will be for internal use only. By completing this application, you agree to let Hickory Hill Farm conduct a background check on you. We will contact you to obtain your Social Security Number. Thank you!
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    Notice of Background Investigation Disclosure

    Hickory Hill Farm, may obtain information about you from a consumer report-ing agency for volunteerism purposes. Thus, you may be the subject of a “consumer re-port” and/or an “investigative consumer report” which may include information about your character, general reputation, personal characteristics, and/or mode of living. These reports may include criminal and civil litigation history information, motor vehicle records (“driving records”), sex offender status (including the National Sex Offender Public Web-site), credit reports, education verification, professional licensure, drug testing, and Social Security Verification. You have the right, upon written request made within a reasonable time after receipt of this notice, to request whether a consumer report has been run about you, and the nature and scope of any investigative consumer report, and request a copy of your report. Please be advised that the nature and scope of the most common form of investigative consumer report obtained with regard to applicants for volunteer-ism is an investigation into criminal background, conducted by ______________ or an-other outside organization. The scope of this notice and authorization is all-encompassing; however, allowing Hickory Hill Day Farm, to obtain from any out-side organization all manner of consumer reports and investigative consumer reports now and, if you are placed in a volunteer role, throughout the course of your placement to the extent permitted by law. As a result, you should carefully consider whether to ex-ercise your right to request disclosure of the nature and scope of any investigative con-sumer report.
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