Team Leader/ Volunteer Application

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Email *

Which position are you interested in filling? *

Team Leader

Volunteer

Presenter

Chef

Administrative Assistant

Marketing Chair

Fundraising Chair

Other:

First Name *

Last Name *

Mailing Address *

City *

State *

Zip Code *

Cell Phone ONLY *

Gender *

Female

Male

Date of Birth *

YYYY

T-Shirt Size *

Small

Medium

Large

X- Large

2X -Large

3X-Large

T-Shirt Sleeve Length *

Short

Long

Describe ways you have contributed or intend to contribute to your community. How do your contributions benefit yourself? How do your contributions benefit your community? *

Masjid Name *

How do you intend to use your skills to make Kamp Khalil a success? *

Do you have any previous experience working with youth? *

Yes

If yes, please detail your experiences below

Reference #1 (name and cell phone#) *

Reference #2 (name and cell phone#) *

Reference #3 (name and cell phone#) *

Medical/Insurance *

Primary Physician's Name and Contact Number *

Allergies and pre-existing conditions *

Liability Release *

I hereby release the Kamp Khalil, their agents, employees, and volunteers from any and all liability

Emergency Contact #1 Name and Number *

Emergency Contact #2 Name and Number *

Physician Release *

I do hereby authorize a physician selected by the coordinator of this event to administer emergency care.

Required

Kamp Khalil strives to provide a well rounded, informative and fun filled week of activities for all volunteers. All volunteers and team leaders are expected to complete and clear Level 2 fingerprinting and background check using our organization code FPKampKhalil1236. Failure to do so will disqualify your application. All volunteers are expected to participate in all of the planned activities, including the outdoor, physical activities, such as volleyball, dodge ball, basketball, canoeing, as well as other games and competitions. Kamp Khalil does not currently have the medical facilities to accommodate volunteers who may have an illness or condition that requires special attention. Volunteers that have undergone surgery within the last 12 months will need to submit a medical release form signed by their physician. Volunteers that are pregnant, are wearing a cast, or have any other medical or physically restricting condition may not be able to serve at Kamp Khalil. Please note that the campground is not handicapped accessible. *

I, the undersigned, have read this release and understand all its terms. I execute it voluntarily on behalf of myself with full knowledge of the significance to bind. In witness whereof, I have signed this release on the date indicated below.

Agree

Required

Signature *

A copy of your responses will be emailed to the address you provided.

Submit

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