STAFF USE ONLY: T_____    C_____    A_____    J_____    D_____

 

 

Hopkins District Day Camp: 2009 Cubs in Space

ADULT APPLICATION

PLEASE READ THE VOLUNTEER SECTION OF THE

APPLICATION COVER LETTER BEFORE PROCEEDING!

 

Name: ____________________________________ Pack: _________________

Address: __________________________________ City/State: _______________ Zip Code: _______

Home Phone (_____) _____________ Work Phone (_____) ________________ Birth date: __________

Email Address:   ___________________________________ (We will NOT share your email address with anyone)

Is a Scout attending Day Camp with you: _YES _NO Name: __________________________ Pack #: ______

5 Day Volunteer: _Mon,Tue,Wed,Thu,Fri

4 Day Volunteer: _Mon,Tue,Thu,Fri or _Mon,Tue,Wed,Thu or _Tue,Wed,Thu,Fri

3 Day Volunteer: _Mon,Thu,Fri or _Tue,Wed,Fri or _Tue,Wed,Thu

1 or 2-Day Volunteers are not required to submit an application. You will be considered a Visitor

(Remember � you can take only one Scout discount per adult volunteer. Discount corresponds to number of days volunteered)

Position at Camp: (Check one)

_ Squad Leader (Overall leader for 8-10 boys, like a Den Leader, you will be assigned assistants � 5 Day Volunteer)

           SQUAD LEADER POSITION MUST HAVE CURRENT YOUTH PROTECTION TRAINING

_ Den Walker (If we do not get enough leaders, some walkers will be assigned as squad leaders)

Squad Leader and Den Leader Note: Barring staffing problems, we will place you with boys from your Pack

_ Station Volunteer   (number your top 3 choices and circle if we can assign you as staff in charge of an area)

YOU MUST BE BSA REGISTERED AND YOUTH PROTECTION TRAINED TO WORK A STATION

___ Adventure (theme based) ____ Science/Nature   ____ Sports   ____ Scout Skills   ____ Any  

____ Shooting Sports   (Slingshot   -- requires day certification course)

All 3, 4 and 5 Day Adult Volunteers MUST BE Trained -

Training will be held on Tuesday, June 16th, 2009 from 7:00-9 PM at the Scout Office.

Please notify us ASAP if you will be unable to attend!

                                   

            Registrations and Certifications:

Currently registered in Scouting? _YES _NO - Must be YES for Station/Staff Position - Attach Copy of Registration Card

Circle one: Pack / Troop: _________ District: ____________________ Current Position: _________________

Current Youth Protection Training _YES _NO - Must be YES for Squad Ldr/Station/Staff Position - Attach Copy of Certification

CPR Trained _YES _NO   First Aid Trained _YES _NO  Attach Copy of Certification(s)

Medical Training: (Include a copy of your most recent certification � required for Camp Inspection)

Please circle your current status of medical training:     None    EMT     RN     LPN     MD     Other _________________

T-Shirts:   1 FREE shirt w/ 3, 4 or 5-day volunteer.  A larger shirt is better than one too small!! Check size!

Adult:        __Small       __Medium        __Large           __Extra Large  __Double Extra Large

Number of shirts:   1 FREE shirt plus _____ additional shirts @ $10.00/shirt ($12.00 XXL) = $ ________ enclosed.       

Medical Information: (No one will be allowed in camp without this form!)

I have attached the required medical form to this registration. Initial Here:                         .

Make one check for the entire family payable to BSA/BAC and attach the check to the Hopkins Day Camp Family Tally Sheet. I understand that by registering for the days stated above, I am committing to be present at Day Camp during that time. If, for any reason, I cannot fulfill my commitment, I will notify the Camp Director as soon as possible. I have read the Application Cover Letter and understand all of the duties expected of me during camp.

Signature: _________________________________________________________   Date: ___________________

 



 

 Hopkins District BAC-BSA - 701 Wyman Park Drive, Baltimore MD 21211 - Phone (443)-573-2527 -
Fax (443)-573-2627