Adult Volunteer Registration

Adult Volunteer Registration Form

* = Fields that are required!

As a note on these online forms, Do not use the enter/return key within boxes for details, just type and let the information wrap itself. Hitting enter or return will cause your information to be lost and the form to fail.

First Name	*	Last Name	*
Street Address	*
City	*	State	*
Zip Code	*
Home Phone	*	Work Phone
Email Address		Cell Phone
Tee-Shirt Size	*	Troop Number(s)
My Camp name
Appointed Leader? **	Yes No	I have volunteered at Camp before	Yes No

Days that you can Volunteer at Camp: Please choose the first option for full time all week volunteering. Otherwise, you can use the second option to check off the days that you are able to volunteer at Camp.

I will Volunteer all week - Note that children of full-week volunteers are guaranteed a place in Camp.	All Week
I will Volunteer on the following days (check all that apply)	Monday Tuesday Wednesday Thursday Friday

Assignment Preference 1st Choice	Assignment Preference 2nd Choice

Comments, if any: Camp Angels, where can you help? Do not use the enter/return key within the box to the right, just type and let the information wrap itself. Hitting enter or return will cause your information to be lost and the form to fail.

Name and grade in the fall (or age if Pre-K) of all my children/dependants attending camp. Remember that each camper will need a separate registration form completed and submitted. If none, then enter 'None'. Please separate multiple entries with commas and do not hit enter/return between entries as this will cause the form to Fail.

(Example: Jodie Smith 1st grade, Martha Smith 6th grade, Kylie Smith 3 years old)

To give each camper the opportunity for their own special camp experience, and to avoid favoritism within Units, camp practice is to place volunteers in Units without their children. However, if you must work in your child's Unit, please specify the reason. Partial-week volunteers will be placed where this is the greatest need and cannot be guaranteed placement with their child.

I must be placed with my child's Unit

Reason:

** If you have not been previously approved as a Girl Scout Leader by Girl Scouts/Columbia River Council, you will be sent further paperwork to complete the application process. To expedite your application, please return the paperwork as soon as possible.

Health History Form
(Must be completed for all Volunteers)

Emergency contact name	*	Emergency contact Phone	*
		Emergency contact 2md Phone

Physician Name

Physician Phone

CONDITIONS
Check those that apply. Explain any checked items in the box below.

Allergies:
Insect Bites/Stings	Medications/Drugs
Hay Fever or Pollen	Food	Other
Chronic or Recurring:
Seizures	Asthma
Diabetes	Other
Other:
Medications given at camp
Medications normally given at home
Other
Check only if there are any restrictions concerning physical activities? (please explain below)

Explanation of items checked above or additional information: Please provide any additional information that would be needed for health and/or safety concerns, or that would be beneficial in helping the staff to prepare for the best camp experience possible. Do not use the enter/return key within the box below, just type and let the information wrap itself. Hitting enter or return will cause your information to be lost and the form to fail.

Are there any other issues or preferences which the staff should be aware? Please let us know if you have any other comments. Do not use the enter/return key within the box below, just type and let the information wrap itself. Hitting enter or return will cause your information to be lost and the form to fail.

Health Professional Information: Please include any additional information that health professionals should be aware of in the unlikely event that you are taken to a hospital, but would otherwise not retract from the Camp experience. Do not use the enter/return key within the box below, just type and let the information wrap itself. Hitting enter or return will cause your information to be lost and the form to fail.

Immunizations:

What was the most recent year of Tetanus shot or DTP immunization?

VOLUNTEER PERMISSION AND RELEASE

I understand and agree to cooperate with all Camp and Girl Scout regulations. I will not attend camp if I am not in good physical condition. In an emergency, I give permission for the Camp authorities to take any emergency measure deemed appropriate. The emergency contact will be notified as soon as possible.

I certify that the health history provided above is complete and accurate. I am able to engage in all prescribed activities, except as noted for exclusion in this form.

I release Columbia River Girl Scout Council, Inc. from any and all liability and damages, including any claim for injuries incurred by myself as a result of participation in this Girl Scout activity.

By typing my name below and clicking the "I AGREE" button, I acknowledge that I fully understand and agree to all provisions of this Permission and Release and that this action is equivalent to signing a printed copy of the Permission and Release.

Name: You must provide complete and accurate first and last name: *

I AGREE: * Must be selected to complete registration.

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