Apply for Volunteer - Camp John Marc

Please fill out the form below and click Submit to submit your application for consideration. Fields with an asterisk (*) are required.

Summary
Title:	Volunteer
ID:	2022
Department:	Weekend
Contact Information
* First Name:
* Last Name:
Preferred or Nick Name:
* Date of Birth:
* Gender:
Preferred Pronouns:
* Email:
* Phone:
* Mailing Address 1 (Permanent address, through May):
Mailing Address 2:
* City:
* State:
* Zip:

Activity Staff Volunteer Criteria

* Activity Staff must:
-be at least 18 years old (with transportation to/from camp)
-be able to safely lift 50 lbs. (with/without reasonable accommodation)
-submit and clear a criminal background check (issued after the application is submitted)
-comply with general health policies and COVID-19 testing if required by the partnering camp.

By selecting yes, I agree that I have read, agree to, and meet the above criteria.

	Yes
	No

Weekend Camp Activities

Below is a list of some of the activities we provide at Camp John Marc that our staff facilitate. Please select any activities you would be comfortable assisting with.

Adventure Activities

	Fishing
	Sports & Games (team building, group games, GaGa Ball, etc)
	Other-list below

Creative Arts

	Arts & Crafts (creating craft lesson plans)
	Pottery (clay or kiln experience)
	Cooking
	Weird Science (gak, slime, volcanoes)

* Please briefly explain any special skills, hobbies, and/or talents you have that would benefit the campers.

* What are your expectations as a CJM volunteer?

Have you previously attended a Camp at Camp John Marc? If so, in what capacity?

	Former Camper
	Former Counselor
	I have not attended Camp John Marc

Name of Camp(s) Attended at Camp John Marc

Have you previously attended a different summer camp (camper or staff member)?

Yes No

If yes, what is the name of the camp?

* How did you hear about Camp John Marc?

* Are you fluent in languages other than English?

Employment History

Please list employment for the previous two (2) summers/years.

* Employer Name/Company #1

* Employer Phone number

* Nature of Work

* Dates Employed

* Reason for leaving

Employer Name/Company #2

Employer Phone number

Nature of Work

Dates Employed

Reason for leaving

Education

* High School Attended:

* Date of High School Graduation:

College(s)/University Attended:

Major/Field of Study:

Current Year in College/University

Date of College/University Graduation

If you have not attended college, please share your comparable life experience:

Medical Information

* For your health and safety, please list any medical conditions you currently have.

* Please list all medications you currently take.

* Please list any allergies you have.

* Please list any restrictions or limitations you have.

* Do you feel you can safely lift 50 pounds (with/without reasonable accommodation)?

	Yes
	No

* Do you currently use any illegal drugs?

	Yes
	No

* Please upload the front of your current COVID-19 vaccination card.

* Please upload the back of your current COVID-19 vaccination card.

* When did you receive your flu vaccination?

Please list any dietary restrictions or preferences you have.

Volunteer Reference

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

* Name of Reference #1 DIFFERENT GENDER

* Reference #1 Phone Number

* Reference #1 Email

* Relationship (Personal or Professional)

* Name of Reference #2 FAMILY MEMBER

* Reference #2 Phone number

* Reference #2 Email

* Relationship (Personal or Professional)

* Name of Reference #3 NON-FAMILY MEMBER

* Reference #3 Phone number

* Reference #3 Email

* Relationship (Personal or Professional)

Emergency Contact

* Emergency Contact Name (First and Last)

* Emergency Contact Phone

* Emergency Contact Relationship to You

Legal Information

* Please list all previous addresses since 18 years of age :

* Do you have a current unrestricted driver's license?

	Yes
	No

If NO, please explain:

* Have you ever been fired and/or terminated from a job, or have you ever been suspended or required to withdraw from a school?

	Yes
	No

If YES, please explain:

* Have you ever been accused of, charged with, and/or convicted of any crime, including child molestation or crime endangering a child?

	Yes
	No

If YES, please explain:

* Have you ever been charged with a DUI and/or other motor offense?

	Yes
	No

If YES, please explain:

Release and Indemnity

Please read this Release and Indemnity Agreement (“Release”) carefully before signing. All references to “Participant” shall be deemed to include staff and volunteers.

* A. PARTICIPATION CONSENT Participant understands and acknowledges that risks and dangers exist during the camp program(s) that Participant has applied to attend and that occasionally accidents occur during camp or retreat activities and that Participant may sustain serious personal injury and property damages as a consequence of such activities. These activities include but are not limited to the potential hazards of boating, swimming, horseback riding, archery, sports, ropes or challenge course exercises, climbing structures, hiking, camping, cooking, and potential hazards of 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. Participant understands that while the user group will have medical staff on-site, the closest emergency room is approximately twenty (20) miles from CJM, and emergency services for the area where CJM is located are volunteer Bosque County EMS. Knowing the risks of camp and retreat activities, nevertheless, Participant agrees to assume those risks. Participant is not under and will not be under the influence of any chemical substance (except prescription medicine taken as prescribed), including alcohol, while at CJM or traveling to or from CJM. Participant understands that participation in this program is entirely voluntary and that Participant may elect to participate, decline to participate, or limit or discontinue participation at any time. Participant has applied for this program and accepts full responsibility for Participant’s decision to participate or not to participate and agrees to follow all safety instructions. Participant understands and agrees that Participant will be in an environment that involves elements related to nature, camping or community living such as insects and insect bites, sun exposure, or communicable illness, including Covid-19.

B. MEDIA RELEASE Participant understands that this media release is granted for the use and benefit of CJM. Participant gives permission and consent for CJM to interview and/or take photographs, audio or audio-visual recordings of Participant and grants CJM permission to use Participant’s likeness or voice in television, film, video, print or other media used to promote or publicize CJM, or the camp session Participant attends; provided these materials are distributed without a specific charge to the recipient except for the cost of precuring any mass media materials in which they are incorporated. I acknowledge that CJM shall have all rights of copyright in and to such photographs, videos, audio and images and may use such copyright fully. I also hereby release Camp John Marc, and Camp John Marc Foundation, Inc. and the user group(s) and their employees, agents and directors, for liability connected with the taking of and use of these materials. In addition, I waive all rights, interest or claims for payment in connection with any exhibition or release of these materials. This consent is voluntary, and I give it in the interest of public information, education, the furtherance of the goals of CJM, or other lawful purposes.

C. RELEASE AND INDEMNITY For and 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(s) sponsoring the camp session I attend, the undersigned, on behalf of myself completely release, acquit, and forever discharge Camp John Marc, Camp John Marc Foundation, Inc. the user group(s) sponsoring the camp session Participant attends, and their respective counselors, employees, volunteers, directors, officers, agents, affiliates, partners, members, shareholders and/or associates (hereinafter collectively referred to as the “Released Parties”) of and from any and all claims, demands, causes of action, obligations, liens, damages, losses, costs, attorneys’ fees and expense of every kind and nature whatsoever, whether for bodily injury, property damage or loss or otherwise, which the undersigned now has or which may arise from or in connection with participation in any activities arranged for me by CJM, the user group(s) sponsoring the camp session, and/or the Released Parties. It is the express intention of the undersigned that this Release is a full release of the Released Parties for the consequences of the Released Parties’ own actual or alleged negligence, gross negligence, strict or absolute liability, or other fault. I agree to be liable for attorneys’ fees and court costs of the Released Parties and myself associated with claims and/or litigation brought by or on behalf of Participant and/or me against CJM, the user group(s) or the Released Parties.

INDEMNITY: It is further expressly agreed and understood that the undersigned will defend, indemnify and hold harmless the Released Parties from any liability, judgment or claim asserted by, through or on behalf of the undersigned who are participating in camp activities, arising out or in any way pertaining to the participation in a camp program and the services and food arranged for the undersigned. The foregoing obligations to defend, indemnify and hold harmless shall be enforceable without regard to the actual or alleged negligence, gross negligence, strict or absolutely liability or other fault of the Released Parties, it being the express intention of the undersigned to indemnify the Released Parties for the consequences of the Released Parties’ own actual or alleged negligence, gross negligence, strict or absolute liability or other fault.

Additionally, Participant 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. Participant consents to either or both Camp John Marc or the user group reviewing this information, checking references (listed or unlisted), and/or conducting a criminal and other background check. Participant understands that if their application is not accepted, they may not be given a reason for that decision and that if selected, such a position will be unpaid and "at will," and can be terminated at any time by Camp John Marc or the user group.

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 employment 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 employment establishes any obligation for the company to accept my application. If I am approved for employment, I understand that either the company or I can terminate my employment 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.

* Signature:

* Today's Date:

I agree that this form may be electronically signed and agree that my typed signature is the same as a handwritten signature for the purposes of validity, enforceability, and admissibility.

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