2014 Day camp volunteer staff registration form Adult’s name______________________________________________________________________________________________ Birth date_______________________________________ Gender: q male q female Shirt size_________________ Position of interest: Please check the position you are interested in: q Unit leader q Assistant unit leader
Address______________________________________________________________ City_________________________________ State___________County_______________________________ ZIP_____________ E-mail address_______________________ Home phone _______________________Work phone_________________________ Cell phone________________________ Authorization section: I give permission for all photos and videos of me at camp to be used for public relations purposes for Girl Scouts of Central Indiana. I understand that I must contact the Camping Services Department or the camp director immediately if I am unable to attend camp. Signature ____________________________________________________________________ Date________________________ Transportation
Disabilities
If bus rider, bus stop code___________________________
assistance. Explain_________________________________
Check one: q Car rider q Bus rider (Dellwood only) q Please check if you need American Disabilities Act __________________________________________________
Bus stop location___________________________________
Do you wish to be in the same unit as your daughter?
Session information Check one:
q Yes q No
q Dellwood q Sycamore Valley
Daughter’s name___________________________________
Session number: (circle one)
You will be assigned based on the needs of the day camp session, not necessarily with your daughter.
1 2 3 4 5 6 7
q Girl Scout Daisy (kindergarten-1)
You are required to be a registered Girl Scout member to work as day camp volunteer staff. Are you currently a registered member of Girl Scouts of Central Indiana?
q Girl Scout Junior (Grades 4-5)
q Yes, Juliette (individual Girl Scout)
Date of session_____________________________________ With what age girls do you prefer to work with?
q Yes, troop #___________ Service unit______________
q Girl Scout Brownie (Grades 2-3)
q No, non-Girl Scout
q Girl Scout Cadette (Grades 6-8)
Out of council
Fee waiver information Name of the girl you are waiving the day camp fee for:
Council name____________________________________ If no, submit an adult membership registration form, volunteer application, and $15 with camp registration.
__________________________________________________ Return your application and the above girl’s application together.
Experience and skills
To waive the total camp fee for your daughter or Girl Scout of your choice, you must attend the pre-camp meeting, attend camp Monday through Friday, and stay on the overnight (Thursday night).
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Have you worked day camp before? q Yes q No
If yes, what years?__________________________________ Position(s) held____________________________________
2014 CAMP GUIDE