Volunteer/Staff Registration
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Volunteer or Staff Member's Full Name *
Address (Include Street, City, State, and Zip Code) *
Last School Attended *
Grade you will enter this coming August *
Volunteer's/Staff Member's E-Mail *
Volunteer's/Staff Member's Cell Phone Number *
Volunteer's/Staff Member's Home Phone Number *
Volunteer's/Staff Member's Social Security Number (SS#) (numbers only, no hyphens) (This is required only in order to check for DCF volunteer clearance and will NOT be shared.) *
Guardian 1/Mother's Name (Do not list if mother does not have custody)
Guardian 1/Mother's Cell Phone Number (Do not list if mother does not have custody)
Guardian 2/Father's Name (Do not list if father does not have custody)
Guardian 2/Father's Cell Phone Number (Do not list if father does not have custody)
Non-Parent Emergency Contact Person Name and Relationship *
Non-Parent Emergency Contact Person's Phone Number *
Volunteer/Staff Member's Gender *
Volunteer/Staff Member's Date of Birth *
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Volunteer/Staff Member's Health Insurance Company (type NONE if you do not have health insurance) *
Volunteer/Staff Member's Health Insurance Group # (type NONE if you do not have health insurance) *
Volunteer/Staff Member's Health Insurance Policy # (type NONE if you do not have health insurance) *
Volunteer/Staff Member's Musical Background (list part you sing of instrument(s) you play.) (Type NONE if you have no musical background.) *
Volunteer/Staff Member's Experience with Children. (Type NONE if you have no experience.) *
Please rate your artistic abilities: *
Volunteer's Additional Talents (list sports you play, hobbies, artistic abilities, other languages you speak, etc.) *
Volunteer's Allergies or Medical Conditions (Type "NONE" if you have none.) *
Are you currently certified in CPR? *
Volunteer/Staff Member's T-Shirt Size. *
Do you have your driver's license? *
Are you a previous camper? *
Are you a previous volunteer? *
VOLUNTEERS: Please check ALL you wish to work (minimum 1 full session). Please read ALL CHOICES for both dates and hours you are available. *
Required
Why do you want to be a MusicMakers! Counselor? (In what ways will you enrich campers' experiences? What do you hope to gain from your time at MusicMakers!, and what will you contribute to the growth of others at camp?) *
MEDIA RELEASE (MANDATORY): ALL boxes MUST be checked in order to be a MusicMakers! Volunteer: *
Required
CERTIFICATION OF GOOD MORAL CHARACTER: If you do NOT check any of the boxes below, please explain WHY in a separate statement emailed to Mrs. Nicole, Camp Director at: musicmakerscamp@aol.com. Failure to do so will invalidate this application. *
Required
How did you hear about MusicMakers! Summer Camp? *
Required
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