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Camp Good Days and Special Times
Summer Program Volunteer Application
Must be 18 years of age to apply
Today’s Date:_________________
Required fields are denoted by *
I will be 17 years of age at the beginning of my program.*
Yes _____ No _______
Applicants Full Name: * ________________________________________________
Street Address: * _____________________________________________________________________
City: *_______________________________ State: * __________ Postal Code: *________________
Country: * _____________ Phone Number: * ___________________
Email Address: * ___________________________________________
I am 18 years of age or older: * Yes ____ No____
Date Of Birth: _______________
______ Please check here if you will be under the age of 18 at the time of your selected program. You
will be automatically selected as a Counselor In Training, and must attend the MANDATORY overnight
training Saturday, June 20, 2015 – Sunday, June 21, 2015 to be considered.
School or Business Address (If Applicable)
Street Address: _______________________________________________________________
City: _______________________________ State:__________ Postal Code: ___________________
Country: _____________
Phone Number: ___________________
Email Address: ___________________________________________
Employment (if Applicable)
Employer: __________________________________________________________________________
Position: _________________________________________________
Do you carry Medical / Health Insurance? *Yes____ No____
If “Yes,” Carrier* ___________________________________
Group Policy # * ___________________________________
ID# *_______________________________
Gender: Male ______ Female ______
Choosing A Program
It is important to understand that we look for people with different experiences. You MUST identify
more than one program that you would be willing to volunteer for. Number the programs by
preference. Please understand that we may ask you to volunteer at a camp session that is not your first
choice. If you choose one program, your application will not be processed. NOTE Volunteers applying for
the Junior Good Days Programs may select only 1 program.
Information on the various programs can be found in the programs section of the web site. Some of the
program descriptions may have changed since last summer.
Please number your top three choices for programs, with “1” being the highest. If you are selected,
more detailed information about each specific program will be forwarded to you.
Camp Childhood USA I
Doing A World Of Good
Camp Childhood USA II
Teddi’s Team
Junior Good Days Rochester
Camp B&ST
Junior Good Days Syracuse
Junior Good Days Buffalo
** I would be interested in volunteering for year-round monthly programs in the following region(s):
Rochester _____ Buffalo ______ Syracuse ______ Ithaca ______
Volunteer Position: Your volunteer responsibilities will be based upon the specific program’s needs. The
majority of volunteers are selected to serve as counselors with the campers in cabins. However, if there
is a specific area in which you would like to volunteer, please indicate that below.
Have you attended any of our programs before? If yes, please indicate program(s) and year(s).
Where did you learn about Camp Good Days?
Do you know anyone involved in any of our programs?
Any certifications you may have that will pertain to your volunteer activity must be current
through September 2015 or later. Copies of all certification cards / licenses MUST be forwarded.
FAX 585-624-5799 Attention Volunteer Coordinator.
Mandatory:* New York State Health Department requires ALL applicants to enclose a biography. We
need to know about you, your experiences with Camp Good Days and Special Times, our programs, or
anything that relates to your dealing with children who have special needs. Please include information
on current certifications, areas of expertise, or any physical disabilities, which you may have, and how
we may accommodate you.
Give the names and addresses of 3 people (not relatives) having knowledge of your character,
experience and ability.
References are required even for returning summer staff. Failure to do so will result in an unprocessed
Name: ____________________________________________________
Address: ______________________________________________________________________
Phone: _________________________
Name: ____________________________________________________
Address: ______________________________________________________________________
Phone: _________________________
Name: ____________________________________________________
Address: ______________________________________________________________________
Phone: _________________________
New York Law requires that all applicants attend a training session prior to their camp session.
Attendance is MANDATORY. If you do not attend the training session, you will not be able to volunteer
at camp.
Please Read Carefully:
I am aware that in being accepted as a volunteer, I am committed to complete the MANDATORY
TRAINING requirement by attending the below checked training program. The information provided by
me in the volunteer application is true and complete to the best of my knowledge. I understand that if I
am selected, any false statements will be considered cause for possible dismissal. You are hereby
authorized to conduct a criminal background investigation of myself.
By volunteering for a camp session, you are making a commitment for the entire session for which you
are selected. Early departure from a program is unfair to the campers and other volunteers; therefore it
is not encouraged. Volunteers are expected to remain on the Camp Property at all times during the
camp session.
______I am a NEW volunteer and I will be attending the MANDATORY training at the Branchport, NY
Recreational Facility on Saturday, June 20, 2015
______I am a RETURNING volunteer and I understand I must attend a training session on the day of or
evening prior to the start of my program
I have been charged or convicted of any crime involving children under 18 years of age*
Yes _______ No_______
If you have, please explain
All Camp Good Days medical forms will be completed online.
Once accepted into a program Camp Good Days will send you a link to its online
medical forms, to the email address provided.
Please enter or sign your full legal name, verifying that you have read, understand, and agree to the
statements written above. *
X___________________________________________________ Date:_________________________
All of the information provided in this form is considered confidential and is not shared with any person or agency outside of Camp
Good Days and Special Times, Inc.
Please Return Completed Forms To:
Jennifer Graham
Volunteer Coordinator
Camp Good Days and Special Times
PO Box 665
1332 Pittsford-Mendon Rd.
Mendon, NY 14506
Email - [email protected]
Fax - 585-624-5799
Phone - 585-624-5555