Volunteer Information

Which programs/projects would you like to help with? Please select all that you are interested in.*
  • Volunteer summer camp counselor (June and July dates available)
  • Outdoor School Assistant (various weekdays from 9-1:30pm during school season)
  • Grounds improvement project (group volunteer projects)
  • Event Help - Camp Fired Up - October 5, 2018 from 5-9pm
  • Club Leader
  • Spring/Fall break camp counselor - dates TBD
When are you available to volunteer with us? *
Are you at least 16 years of age?
  • Yes
  • No
Where did you hear about volunteering with Camp Fire?
T- Shirt Size
  • x-small
  • small
  • medium
  • large
  • x large
  • 2x

Contact Information

Country*
State / Province*
Address*
City*
*
*
*
*
*
*
Email*
Confirm Email*
Phone*
DOB
Place of Employment
Occupation
Social Security #
Other names by which known
Drivers License #
DL State
Expiration Date
Emergency Contact Name
Emergency Contact Phone Number
Have you ever been convicted of any crime relating in any manner to children and/or your conduct with them?
  • Yes
  • No
Have you ever been convicted of any crime including, but not limited to, those listed below and/or any crime similar in any manner to those listed below?
  • Yes
  • No
      • Indecent assault and battery on a child under fourteen
      • Indecent assault and battery on an individual with a intellectual disability.
      • Indecent assault and battery on a person who has obtained the age of fourteen
      • Rape
      • Rape of a child under sixteen with force
      • Assault with intent to commit rape
      • Kidnapping of a child under sixteen with intent to commit rape
      • Distribution and trafficking of narcotics or other controlled substances
      • Intent to commit any of the above crimes.
Have you ever been adjudged liable for civil penalties or damages involving sexual or physical abuse of children?
  • Yes
  • No
Are you now or have you ever been subject to any court order involving sexual or physical abuse of a minor, including, but not limited to a domestic order or protection?
  • Yes
  • No
Have your parental rights ever been terminated for reasons involving sexual or physical abuse of children
  • Yes
  • No
If yes to any questions above, please explain

I understand that:

 

  • Camp Fire may deny employment to any person who answers “yes” to any one of questions 2-6. If hired and the employer later discovers circumstances that would indicate a “yes” answer to any of the above questions, employment may be terminated immediately.
  • The information provided on this form is subject to verification, which may include a criminal history check and request from any Central Registry of child abusers.
  • The camp may terminate employment or volunteer service of any person if that person is found, regardless of when discovered, to:
    • have a history of complaints of abuse of a minor;
    • have resigned, been terminated, or been asked to resign from a position whether paid or unpaid, due to complaint(s) of sexual abuse of a minor; and/or
    • have falsified or omitted information in this disclosure statement.
  • This disclosure statement must be updated yearly.
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