Volunteer Application

- Must be 18 years of age or older.
- Responsible for transportation to and from weekend retreat.
- Meals and lodging will be provided by Camp Hands of Hope.
- You will be lodging in a room with other volunteers of the same gender.
- We do not accept room assignment requests for lodging.
- You will be staying on bunk beds and we encourage you to bring a sleeping bag/blanket along with your own pillow for comfort.
- You must complete a virtual training session prior to attending camp. MANDATORY TRAINING sessions are held online. You MUST be able to attend training on BOTH of these dates: Thursday, September 29 at 7:00 PM (large group training) AND Wednesday, October 5 at 7:00 PM (small group training)
- Must be able to attend the entire weekend. If there is a potential schedule conflict, please discuss with us before applying.

Date of Birth (MM/DD/YYYY) *

Have you ever been charged and or convicted of any type of sexual misconduct? *

Yes No

If you selected YES to the previous question, please explain. Otherwise type N/A (we run background checks on all potential volunteers) *

Occupation *

Volunteer's T-Shirt Size *

Employer *

Contact Information

Address *

Line 1

Line 2

City

State

Zip Code

Country

Email (one you check frequently) *

Primary Contact Phone Number *

Secondary Contact Phone Number *

Emergency Contact Name *

First

Last

Emergency Contact Phone Number *

Camp Information

Bereavement Information

Medical Information
This information will only be utilized and referenced by the Camp Director and Camp Nurse. Information disclosed in this section is considered confidential and will not impact your opportunity to volunteer in any way.

Do you have an allergies or dietary restriction? (if yes, please explain; if no, please type "n/a") *

Do you take any prescription medications? *

Do you have any medical, physical, or mental health conditions of limitations? (if yes, please explain; if none, please type "n/a") *

Are you able to get on the floor/ground and interact with children at their level? *

Yes No

Volunteer spaces are limited. Volunteers with certified/licensed experience working with end of life issues, bereavement, and youth will be given preferred placement ahead of those who are not certified/licensed. Although we attempt to place every volunteer, we reserve the right to decline applications as needed. Thank you for understanding.

Statement of Confidentiality *

I understand that in the course of volunteering with Camp Hands of Hope, a program under the Hospice & Palliative Care Foundation, I may learn certain facts about individuals and families. All of the information that I may have or potential have access to regarding any of the families is confidential. By checking this box and typing my name below, I understand all information I have access to must be kept confidential. Under no circumstance am I allowed to disclose any information regarding any of the families or children to friends, family, media, or any other unauthorized or unaffiliated persons for any reason. If there is a media inquiry, I will forward it along to the Director of Camp Hands of Hope.

Statement of Consent for Background Check *

By checking this box and typing my name below, I agree to allow the Hospice & Palliative Care Foundation, through Camp Hands of Hope, to run a background check on me. I understand and give them permission to review and keep this document on file. I understand that my ability to volunteer may be determined and/or influenced by the result of the background check.

Please read and check box below *

I hereby certify that all of the information above is accurate to the best of my knowledge.