PHILANTHROPY CAMP 2016

PHILANTHROPY CAMP 2016 Counselor Application

Rising grades 10, 11, 12 to 18 years old

Camp Date: August 1 – August 5, 2016 (You must be available every day-all day)

Time: 8:30 a.m. to 4:45 p.m. daily

Location: First Church of the Nazarene/Jewish Cultural Center

5455/5461 North Terrace Road, Chattanooga, TN 37411

Compulsory Training Sessions – Wednesday (July 27) 4-8 pm, Thursday (July 28)4-8 pm and Friday (July 29)10-2pm. Meals included

Philanthropy Camp is a one-week day camp designed to provide elementary-age children with opportunities to give back to others, and to understand the positive differences they can make in their own community. Through hands-on-activities campers will explore the concept of and the relationship between philanthropy, faith, family, and community. Philanthropy Camp is a joint program of Chattanooga First Church of the Nazarene and the Jewish Federation of Greater Chattanooga.

Teen volunteer registration forms will not be accepted after 5:00 p.m., Friday, April 18. In-person interviews will take place during the months of May and June. The interview itself is not a guarantee of acceptance. All acceptances are at the discretion of the Director. All volunteers 18 years and older will be asked to submit information for a background check.

Invited returning counselors, please complete the general form and the medical form. If you have been invited to return there is no need for you to complete the application portion.

All volunteers, without exception, must be in attendance at the training sessions listed above. Meals are included during training.

Teen volunteers are responsible for their transportation to and from camp, and are expected to be at camp for the entire day, every day. Training and camp are no cell phone zones unless advised differently.

Philanthropy Camp Teen Counselor Application 2018

This application must be completed in its entirety. It a section does not apply please indicate with N/A.

Teen Counselor Applicant Information
Name*
First Last
Preferred Name
Age*
Birth Date*
Month
Day
Year
Male/Female*
Grade entering in the Fall*
Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Email*
Licensed driver?*
Will you be driving to and from camp?*
If you drive to camp, you agree that your car will remain in the parking lot until the end of the camp day. You will not be permitted to leave the camp site for lunch or other breaks.
T-shirt size*
Parent/Guardian 1 Information
Name*
First Last
Home Phone
Email*
Address*
Street Address Address Line 2 City State ZIP Code
Work Phone
Cell phone
Teen Counselor Application Questionnaire
The following questionnaire must be completed in full.
Have you ever attended camp?*
If yes, which? List your favorite camp experiences and why.
Have you worked with young children before?*
If yes, when and in what capacity?
Have you had any prior leadership training and/or camp counselor experience?*
If yes, please state where and when
List any special skills/talents/certification or other personal accomplishments*
Is there any information about yourself that you would like the selection committee to know that we have not asked?
Please give a thoughful response (limit 250 words) to the questions below*
Share with us your ideas of what you think philanthropy is. Why do you want to be a teen volunteer for Philanthropy Camp? What do you hope to contribute, and gain from being a teen volunteer?
Teen Volunteer Expectations/Behavior Contract
1. Policy and procedures have been put in place for the safety of all. Teen assistants are expected to follow all directions as given by the Camp Director, Program Director, Teen Leader, and others deemed to be in a supervisory position.
2. Always speak with an adult staff member if you have a question or a problem during camp. Every situation is a learning opportunity, and the adults on staff are here to help and guide you.
3. Always conduct yourself in a respectful manner. Consider your attire, personal habits and attitude. You are a role model. Young children admire and follow teen actions.
4. Always be kind, courteous and helpful. Your helping hands and positive presence will aid in the development and promotion of the camp’s philanthropic experiences.
5. Pay close attention to the young campers under your direction.
Cell phones are strictly prohibited during camp hours. Your full attention is required at all times. 6. Assist with all parts of camp which include, but are not limited to, activity set-up and clean-up, and camper supervision. Teen volunteers are expected to participate in all activities.
7. Arrive promptly at 8:30 a.m. for set-up. Leave after 4:40 p.m. following clean-up. Teen volunteers who drive to camp are not permitted to use his/her car during camp hours.

Remember, you are the face of Philanthropy Camp, The First Church of the Nazarene, and the Jewish Cultural Center. Your actions and behavior should always promote positive attitudes for positive outcomes.

The teen volunteer recognizes that his/her actions can positively or negatively impact the camp community. The teen volunteer must follow the above expectations, and comply with the general rules set out by Philanthropy Camp. All teen volunteers will work diligently to create a safe and enjoyable environment so all may enjoy the benefits of a healthy and happy summer camp atmosphere.

Should a teen volunteer demonstrate inappropriate behavior, the following steps will be taken:

1. The Camp Directors and/or another staff person will discuss the behavior issue with the teen volunteer.
2. If inappropriate behavior continues, the teen volunteer may be reassigned or asked to leave the camp.

I have read and understand the Philanthropy Camp Behavior Contract.
Signature of teen applicant*
Date*
Month
Day
Year
Additional Emergency Contact
If parents cannot be reached
Name*
Relation to teen*
Home Phone
Cell Phone
Please list other adults to whom your teen may be released or who may provide transportation
Is there anyone who may not pick up your teen?
Parent/Guardian Authorization - Release
PARENT/GUARDIAN AUTHORIZATION - RELEASE I am the parent or legal guardian of ______________________________ (the “Participant”), who has my permission to participate in all programs and activities in Philanthropy Camp. I recognize and acknowledge that participation in the camp necessarily involves the risks of accident, personal injury and/or property damage. I consent to the Participant’s participation in the camp and assume all these risks in connection with the camp. Participating in any activity is an acceptance of some risk of injury and I agree that the Participant is primarily dependent on his/her taking proper care of him/herself. Accordingly, in consideration for Chattanooga First Church of the Nazarene and the Jewish Federation of Greater Chattanooga (hereafter called the organizations) allowing the Participant to participate in the camp, I hereby release both organizations, its officers, directors, employees, agents, and volunteers from any and all claims, causes of action, injuries, damages and liabilities allegedly caused by any negligent act or omission of the organizations, arising out of or relating to participation in the camp. Additionally, in consideration of the organization’s allowing the Participant to participate in the camp, I hereby agree to indemnify and hold harmless the organizations for any and all costs, losses, damage, or expense, including attorney’s fees, arising out of any claim for personal injuries allegedly caused by any negligent act or omission of the organizations, arising out of or relating to participation in the camp. I agree that Participant is attending the camp voluntarily and for purely recreational purposes. Additionally, I agree to allow the organizations to use pictures of my teen for promotional and news purposes. I agree to allow the organizations to transport my teen to and from program activities by licensed adults over the age of 18, in private or the organizations vehicles or in the event of an emergency.
Parent/Guardian Signature*
Date*
Month
Day
Year
MEDCIAL INFORMATION FOR EACH TEEN VOLUNTEER
Teen volunteer name*
First Last
Physician Name*
First Last
Phone
Insurance Company*
Policy Number*
Date when teen last received MMR shot*
Date when teen last received Tetanus shot*
Does your teen have any allergies that we should be aware of?*
If yes, please explain
List any conditions that may have been diagnosed by a physician, psychologist, or psychiatrist
Does your teen have any learning or behavior challenges?
Does your teen have any special conditions not already addressed? If so, please describe
Will your teen be taking any medication, including over-the-counter, during summer camp?*
This includes medicines taken before arriving and after departing summer camp.
Will the oganizations staff be required to administer the medication for the teen?*
Will your teen be taking any medications beyond their expiration date?*
The organizations staff cannot administer expired medication.
If you answered yes above, you must provide the medications and complete information below.
Please include dosage amount, and its schedule or indication or taking medicine.
Special activities to be encouraged or restricted
Special dietary regimen to be followed (e.g. vegetarian, lactose intolerant)
Does your teen carry an epi-pen?*
Doctor's Authorization
If the organizations staff needs to administer an Epi-pen, you must obtain the prescribing physician's authorization
Doctor's Name
First Last
Doctor's Signature
Date
Month
Day
Year
Medical Authorization
I authorize the Organizations staff to give the medications listed to my teen: over the counter, prescribed, emergency medicines – Epi-pen etc. I authorize the organizations staff to give permission for medical treatment of my child in the event of an emergency. I also certify that the personal and medical information contained herein is true and correct to the best of my knowledge.I authorize the Organizations staff to give the medications listed to my teen: over the counter, prescribed, emergency medicines – Epi-pen etc. I authorize the organizations staff to give permission for medical treatment of my child in the event of an emergency. I also certify that the personal and medical information contained herein is true and correct to the best of my knowledge.
Parent/Guardian Signature
Date
Month
Day
Year
CAPTCHA

Mon – Thur	9:00am – 5:00pm
Friday	9:00am – 4:00pm

PHILANTHROPY CAMP 2016

Philanthropy Camp Teen Counselor Application 2018

Teen Counselor Applicant Information

Parent/Guardian 1 Information

Teen Counselor Application Questionnaire

Teen Volunteer Expectations/Behavior Contract

Additional Emergency Contact

Parent/Guardian Authorization - Release

MEDCIAL INFORMATION FOR EACH TEEN VOLUNTEER

Doctor's Authorization

Medical Authorization