Camp Circle Star Volunteer Application
Volunteers must be age 16 or over
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Email *
Name First Last *
Address  City   State    Zip *
Cell Number *
T Shirt Size-Not provided for single day volunteers *
Date of Birth *
MM
/
DD
/
YYYY
Gender *
In case of emergency, please contact, Phone *
High School, Dates Attended, Degrees
College/University, Dates Attended, Degrees
Have you worked with people with disabilities before? *
If yes, please briefly describe your experience.
We provide transportation from the Sam’s Club at 13455 Manchester Rd, 63131. We meet at 8am and return at 4pm. You may park your car there for the day. Will you be using our transportation?  *
Do you have a history of drug or alcohol abuse? *
Volunteers at Camp Circle Star are required to be at their camper's side at all times for safety.  This  includes activities such as swimming, running, jumping, and hiking.  Please check below that you are aware of these requirements.  *
Required
Do you have knowledge of any condition (back, knees, other) which would prevent you from lifting/carrying 40 lbs.? *
Have you ever been charged or convicted of physical or sexual abuse or neglect? *
Please list any allergies.
Do you have any physical or cognitive challenges that may limit your performance in the volunteer position you are applying for? *
If so, what can be done to support you?
I would like to volunteer the following dates (check all you are interested in):       *
Required
I hereby certify that the answers given by me to the questions and statements above are true and correct, without reservations of any kind whatsoever, and that no attempt has been made by me to conceal pertinent information. (Signature & Date) *
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