One moment please...
First Time Volunteer Application
Contact Information
*

First Name
Last Name
*

*

*

(mm/dd/yyyy)
*
*

*

*

First Name
Last Name
*

Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code
Country
*

*

Please list the areas you have lived since the age of 16. City, State, length of residence (e.g. Dallas, Tx, June 2011-August 2012)
Education
*

School, Dates Attended, Degree
*

School, Dates Attended, Degree
Emergency Contact
*

First Name
Last Name
*

*

Short Answer Questions
*

*

*

*

*

*

*

*

*

References
Please list the details of three (3) persons who have knowledge of your character, experience, and abilities. One reference must be a person of the opposite gender, one a family member, and one non-family members. Please note, current contact information is required for all references.
*

First Name
Last Name
*

*

*

First Name
Last Name
*

*

*

First Name
Last Name
*

*

Activity Areas
Please complete this section if you are applying to be a weekend camp volunteer. Side/Lead Walker Volunteers do not need to complete this section.
Please check the activity areas that you have experience with and would feel comfortable leading. Those areas which require a certification are marked with an asterisk.


Medical Information
*

*

*

*
*
*
PLEASE NOTE, IN EFFORT TO PROTECT THE HEALTH AND WELL BEING OF OUR CAMPERS DURING THIS INTENSE FLU SEASON, CAMP JOHN MARC IS REQUIRING ALL STAFF AND VOLUNTEERS TO HAVE A FLU SHOT DURING THE MONTHS OF FEBRUARY AND MARCH.
*

(mm/dd/yyyy)
*

First Name
Last Name
*

Camp John Marc Release

I understand that the information on this application is submitted for the use and benefit of both Camp John Marc and the user group sponsoring any specific camp session. I consent to either or both Camp John Marc or the user group reviewing this information, checking my references (listed or unlisted), and/or conducting a criminal and other background check. I understand that if my application is not accepted, I may not be given a reason for that decision and that if selected, my position will be unpaid and "at will," and can be terminated at any time by Camp John Marc or the user group.

 

If my application is accepted, I grant Camp John Marc and the user group permission to use, without compensation, my likeness or my voice in television, film, video, film, print or other media used to promote or publicize Camp John Marc, the user group, or the camp session I attend; provided these materials are distributed without a specific charge to the recipient except for the cost of procuring any mass media materials in which they are incorporated.

 

I acknowledge that during the camp program(s) that I have applied to attend that certain risks and dangers exist. These include, but are not limited to the hazards of boating, swimming, horseback riding, riflery, archery, sports, ropes or challenge course exercises, climbing structures, wilderness hiking and camping, the presence of wildlife, depending on other people, accident or illness, the forces of nature, extreme temperature, inclement weather, and travel by air, train, boat, automobile, or other conveyance. I also recognize that these risks may also include loss or damage to personal property, physical or psychological damage and/or injury, not excluding fatality due to accidents which may occur, including accidents resulting from vigorous outdoor activities. I further understand that emergency medical treatment may be several hours away in the event of a medical emergency due to the remote location of the facility.

 

I am not under, and will not be under the influence of any chemical substance (except prescription medicine), including alcohol, while at camp or traveling to or from camp. I understand that my participating in this program is entirely voluntary and that I can elect to participate, decline to participate, or limit or discontinue participating at any time. I have applied for this program and take full responsibility for my decision to participate or not to participate and agree to follow all safety instructions, and I understand Camp John Marc's and its user groups' decisions to allow me to participate as based on information I have given in my health statement.

 

In consideration of the right to participate in a camp program and the services and food arranged for me by Camp John Marc, the user group sponsoring the camp session I attend, and their respective shareholders, members, directors, officers, employees, agents, volunteers, and/or associates, I have and do hereby assume all the above and similar risks whether or not specifically foreseeable, and will hold all of them harmless from any and all liability, actions, causes of action, debts, claims and demands of every kind and nature whatsoever, whether for bodily injury, property damage or loss or otherwise, which I now have or which may arise from or in connection with participation in any activities arranged for me by Camp John Marc, the user group sponsoring the camp session I attend, and their respective shareholders, members, directors, officers, employees, agents, volunteers, and/or associates, and their heirs, executors and administrators, successors and assigns and for all members of my family, including any minor children of mine accompanying me. I acknowledge and agree that I will not sue Camp John Marc or its user groups or such other related parties, and that if I do, I cannot collect any money for any injury to person or property. To the extent that this agreement may ever be construed so as not to effect a full release or to be otherwise less than fully enforceable, it shall be construed as a full release of Camp John Marc, its user groups and such other related persons from any liability for gross negligence, negligence, or strict or absolute liability. I agree to be liable for attorney and court fees associated with any unsuccessful litigation brought by me against Camp John Marc or such other related parties.

 

*
Background Check Verification & Release
*
Authorization and Acknowledgement
The facts set forth in this application and any supplemental information are true and complete to the best of my knowledge. I understand that, if my application for volunteering is accepted, falsified statements on this application shall be considered sufficient cause for immediate discharge. I hereby authorize investigation of all statements contained herein and employers listed above to give you any and all information concerning my employment, and any pertinent information they may have, and release all parties from all liability for any damage that may result from furnishing same.
I understand that neither the completion of this application nor any other part of my consideration for volunteering establishes any obligation for the company to accept my application. If I am approved for volunteering, I understand that either the company or I can terminate my volunteer role at any time and for any reason, with or without cause and without prior notice. I understand that no representative of the company has the authority to make any assurance to the contrary.

I understand that I am required to abide by all rules and regulations of the company.
*
*

*

(mm/dd/yyyy)