2021 Volunteer Application 2021 Adult Volunteer Application Please completely fill-out this application to assist us in reviewing your Volunteer Application. After submitting this application, you will be contacted by a volunteer application committee member who will notify you regarding the status of your application. If anything regarding the information you provided between now and the start of camp changes, please contact firstname.lastname@example.org so we can have the most up-to-date information. Last minute cancellations cause great hardship for camp planning and safety. Please consult your personal calendar carefully before committing to the volunteer dates – thank you!Contact InformationKiwanis Club Affiliation (if any): Are you a past counselor?* Yes No Name*Legal names are needed for background checks. First Middle Last Date of Birth:* MM slash DD slash YYYY Address:* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Email:* Primary Phone Number* HomeWorkMobileOther Type Phone Secondary Phone Number HomeWorkMobileOther Type Phone Emergency ContactName:* Name Relation Phone Medical InformationWe will be requiring all counselors and volunteers to be fully vaccinated by the time of Camp. Are you or will you be fully vaccinated before camp? Yes No Depending on the WA state guidelines at the time of camp, will you be comfortable in a camp setting where masks are not mandatory? Yes No Do you understand that if you begin to experience symptoms that fall under the category of COVID-19, you will need to be tested and obtain a negative test prior to attending camp? Yes No In the event of a medical emergency, what information will an EMT or medical personal attending to your care need to know?Dietary*Note: The Camp Casey kitchen staff will do their best to accommodate common food allergies. However, given the complexity and procedures for vegan diets the kitchen staff will not be able to provide vegan meals. Additionally, we cannot guarantee a completely gluten free kitchen as other meals will be prepare including gluten in the same space. Sorry for the inconvenience. Gluten Intolerant Celiac Disease Lactose Intolerant Peanut Allergy Vegetarian No Food Restirctions Other Please elaborate on your additional dietary restrictionsTime at CampCamp dates are Monday, July 26 through Friday, July 30th. We are switching to a day camp model this year, and volunteers will be required to transport themselves to and from Magnuson Park between the hours of 8am and 5pm.Desired Days to Volunteer:*Please provide us the desired days you'd like to volunteer. We plan meal count based on the number of volunteers and campers on campus. The dates in order are: Monday, July 26th, 2020 Tuesday, July 27th, 2020 Wednesday, July 28th, 2020 Thursday, July 29th, 2020 Friday, July 30th, 2020 Monday Tuesday Wednesday Thursday Friday Please provide us time availability for the dates you provided above.What time will you arrive?* 6 am to 10 am 10 am to 2 pm (must arrive by noon for lunch) 2 pm to 6 pm 6 pm to 10 pm 10 pm to 6 am What time will you depart?* 6 am to 10 am 10 am to 2 pm 2 pm to 6 pm 6 pm to 10 pm 10 pm to 6 am Other questions or comments.Please provide any question or comments that will help with the application process.Camp Casey T-shirt:Would you like to order a Camp Casey T-shirt? (T-shirts are free to all volunteers who sign up prior to July 1) If you would like to order a t-shirt after this date the cost is $10) Please indicate size below. *Anything ordered after July 15 delivery cannot be guaranteed. Small Medium Large X-Large XX-Large XXX-Large Background CheckPursuant to requirements of RCW 43.43.834 Washington state rules, Kiwanis Camp Casey must ask all volunteers to complete the following disclosure statement. Please answer fully and accurately. Background inquires will be made to the Washington State Patrol or other criminal history and federal exclusion data bases. Applicants must sign a release authorizing such background inquires. Failure to do so or to provide a complete Disclosure Statement shall prevent the applicant from volunteering with Kiwanis Camp Casey and related activities. N.C. Kiwanis leadership specifically assigns the 'background check process' in such a way that confidentiality is strictly protected regarding the official reports received. Our goal is to fulfill our due diligence as required by law and provide the safest possible camp experience for our campers. Applicants who are refused acceptance due to results of the background check will be informed in writing. Thank you for your cooperation. Have you been convicted of a crime? Yes No Have you had findings made against you in any civil adjudicative proceeding? Yes No AcknowledgementPlease read and agree to the forms below. * Kiwanis volunteers bringing children must have prior permission from the Camp Director or Volunteer Coordinator and must review and sign a Policy for Kiwanis children volunteering at Kiwanis Camp Casey.Please read Camp Casey Counselor Volunteer Code of Conduct.* I have reviewed the Counselor Volunteer Code of Conduct. I know what is expected and agree to the guidelines specified. I will be at least 18 years of age on July 24, 2021 Yes No Please note you will be asked to read and sign the Camp Casey Counselor Volunteer Release Form before attending Camp.* I acknowledge that I will be asked to review the Release Form prior to attending camp. Agreement will be mandatory prior to attending camp. Please read Camp Casey Counselor Volunteer Release Form.*Since you will be under 18 years of age when camp starts, please print and fill out the Volunteer Release form. Instructions on where it is to be sent are at the bottom of the form. I have reviewed the Volunteer Release Form. I know what is expected and agree to the guidelines specified.