2024 Camp ChiMer Volunteer Form

Contact Information

First Name

Middle Name

Last Name

What would you like to be called? (Preferred first name)

Please list your preferred pronouns

Birthdate

Primary Phone Number

Street Address

City

State

Zip/Postal Code

What is your t-shirt size?

What is the best way to reach you?

Additional Information

What is your occupation ("Student" if you are a student)?

Please list your company/school.

Do you speak any languages other than English?

Please list any languages you speak other than English.

How many years have you been a volunteer at Camp ChiMer?

In Case of Emergency

Emergency Contact Info

Emergency Contact Name

Relationship to Emergency Contact

Emergency Contact Phone

Emergency Contact Street

Emergency Contact City

Emergency Contact State

Emergency Contact Zip

Please List any Known Allergies ("None" if you have no allergies)

Please list any medical conditions that you want us to know about while you are at camp.

Please list information for your physician in case of a medical emergency (Name and Phone Number)

Camp Volunteer Questions

Tell us about your experience working with children in a leadership role.

Tell us about hobbies, talents, or skills you have that you are excited to contribute to the camp experience.

Anything else you'd like to share?

Do you have transportation to and from camp?

Do you need support with transportation or accommodation in order to volunteer at camp?

What support do you need?

Camp will be in session, including overnight, Friday 8/02/24–Sunday 8/04/24. What day/s are you available to volunteer?

Please specify, noting the days and hours you are available:

All new volunteers will participate in a 30 minute Zoom interview, if able. Do you have access to Zoom, or do you need to connect over the phone?

Health & Safety Requirements

Read and initial at the bottom of each section below to acknowledge that you have read these requirements, and you understand that after reviewing this application form we will follow up with you to provide more information and instructions.

Liability Acknowledgement

I am aware that COVID-19 is an extremely contagious disease and that an inherent risk of exposure to COVID-19 is present in any public place. By attending or organizing this event and signing this form, I expressly warrant that:

· Except to the extent of negligence or willful misconduct by NKF, I will indemnify and hold the National Kidney Foundation (NKF) harmless from any and all claims of any kind or nature whatsoever arising out of, or in any way related to, my negligence or willful misconduct relating to my participation in this fundraising initiative.

· Except to the extent of negligence or willful misconduct by NKF, I will indemnify and hold the NKF harmless from any and all claims of any kind or nature whatsoever arising out of, or in any way related to my alleged exposure to, or my contracting of, COVID-19 during or after the Event.

· I voluntarily assume all risks related to exposure to COVID-19 and if required, I agree to follow all rules established by the Center for Disease Control, the state in which the event occurs, and the event venue.

· I will not attend any NKF event if I have tested positive for COVID-19.

· I also give permission for the free use of my picture in any media or other account of these events.

In consideration for being permitted to organize or participate in this event, I, the undersigned, covenant not to sue and waive and release NKF and its directors, officers, employees, volunteers, agents, and supervisors (collectively, the “Releasees”), from any and all claims, liabilities, or causes of action arising out of an injury to me or loss or damage to property, except to the extent of negligence or willful misconduct by NKF. Furthermore, I agree to be responsible for any damages attributable to my negligence or willful misconduct.

I acknowledge I have carefully read, accept, and agree to the terms of this Liability Waiver, and know and understand their contents and, I agree of my own free will without any inducement, assurance or guarantee being made to me and intend my signature to be a complete and unconditional release of liability to the greatest extent allowed by law.

Initial Below to Acknowledge

Application Requirements

All camp volunteers will be required to attend training 7:00AM Friday, August 2nd at Three Trails.

All camp volunteers will be required to consent to a background check.

All camp volunteers will be required to complete sexual harassment training online.

Initial Below to Acknowledge

You will receive detailed information about the above requirements with your onboarding materials, including when they are due and how to submit or complete them. Please ensure we have the best email address to communicate everything to you.

Contact Information