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4-H Camp Chaperone Application
Crawford, Richland, Monroe, La Crosse and Vernon Counties
Counselor Training: TBA April @ Upham Woods (Optional)
Counselor and Chaperone Orientation: June 15, 2024
Camp Dates: July 31-August 2, 2024 Upham Woods, WI Dells
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Email
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Name
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Address (City and Zip)
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Phone
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Cell Phone
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Email
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County
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T-Shirt Size
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S
M
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XXL
Are you currently a certified 4-H volunteer?
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Yes
No
Do you have a child who will be attending 4-H Summer Camp?
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Yes
No
What age group do you prefer to work with during camp? (select all that apply)
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3rd & 4th grades
5th & 6th grades
7th & 8th grades
Required
Describe any past camp and/or chaperoning experience.
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What interests you about chaperoning? What are your expectations?
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Volunteers are essential to a successful camp! All adult volunteers will be counted as chaperones, but please indicate below if there are any additional areas you would like to assist with during 4-H Summer Camp.
Camp Nurse
Photographer
Dining Hall Coordinator
Archery
I have a skill I want to share that's not listed - please reach out!
What to Expect as a 4-H Camp Chaperone
Your role is to support the efforts of youth camp counselors. You will not be in a lead role, but rather, as a supporting cast member, you will work behind the scenes to help everything go smoothly. You will be assigned to accompany and reside with a cabin group with 10-15 kids and 2-3 counselors.
Time Commitment: 4-H Summer Camp is a three day program. We anticipate you'll want to engage in most camp activities, however you will also have some down time.
Transportation: Some counties may require your assistance to fulfill ratio on the bus to and from camp. If you prefer to drive your own vehicle, please contact your 4-H Educator.
Your Camp Registration Fee is covered.
Housing: Chaperones stay in the cabins with their group of counselors and youth. This may or may not include your child(ren).
Meals and snacks are provided - including coffee!
Remember that you are a role model for both the counselors and the campers and that FUN is included!
Expectation Agreement for Area 13 4-H Summer Camp
If selected as an Adult Camp Chaperone I understand and agree that:
My role at camps is to provide a positive, nurturing, fun environment for campers and counselors
I will treat other staff, counselors, and campers with dignity and respect
I will not allow or participate in any kinds of initiation activities (skits, pranks, jokes) during camp.
I will attend all meals, campfires, and evening programs unless assigned other duties by the Camp Directors.
I understand that the use and possession at camp of any alcohol, tobacco, or other drugs is cause for instant dismissal.
I understand that verbal, sexual or physical abuse towards other people; including staff, counselors or campers is instant dismissal.
I will only use my cell phone for personal use when away from campers and counselors (using it to take appropriate pictures of activities or camp use is permissible).
I will remain at Upham Woods during the camp sessions, unless approved by a Camp Director.
I will follow all rules and regulations set forth by Upham Woods Outdoor Learning Center.
I understand that if I break any of these expectations listed above that my actions could results in my early departure from camp, removal as a leader in the Wisconsin 4-H program, additional county action.
Please write your name below to show agreement with the statements above.
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An EEO/AA employer, University of Wisconsin-Extension provides equal opportunities in employment and programming, including Title VI, Title IX, and the Americans with Disabilities Act (ADA) requirements.
A copy of your responses will be emailed to the address you provided.
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