Camp Goodtimes Provider Application 2024
All prospective providers need to submit this application to be considered for service at Camp Goodtimes this summer. Please share the required background information and your availability and await contact from Goodtimes to confirm whether our need and your availability align. (Submission does not equate to being hired.)
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First & Last Name
Email Address: to receive camp-related info
Personal Cell Phone Number: to receive camp-related texts/calls before, during, and after camp
Pronouns
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Hospital/Clinic Employed By
Department at Your Hospital/Clinic (ex. oncology, ER, etc)
Your Medical License/Credential Number
Camp Goodtimes requires providers to not only have a valid license, but to also have had clinical hours (direct patient care) within the last 24 months. Do you meet this requirement?
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Have you volunteered at Camp Goodtimes before or would this be your first time?
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Camp Name (if a veteran volunteer at Camp Goodtimes)
Availability
We need a provider onsite whenever campers are present (campers arrive Sunday afternoon and leave the following Saturday afternoon). It can also be helpful to have a provider onsite during staff training weekend to help set up the MedShed space, connect with the nurse lead and team, and to get acclimated (in addition to getting to know your fellow volunteers!).

Unless noted, 24-hour shifts start at 7:00 pm and end at 7:00 pm the following day. 
June Camp (June 21-29; campers arrive on June 23): check all days that you're available
July Camp (July 12-20; campers arrive on July 14): check all days that you're available
Are the dates above already confirmed time off for you or are you/will you be awaiting confirmation of a time-off request from your employer?
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Background Check Info
The following information needs to be collected in order for The Goodtimes Project/Camp Goodtimes to run a background check. We do this for all volunteers to ensure the safety of our campers.
Date of Birth (month/day/year)
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DD
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YYYY
Social Security Number (this information will only be used to facilitate a background check)
At-Camp Information
If invited to serve at camp, the following information will help us ensure you have a pleasant and safe experience.
T-shirt Size (unisex sizing)
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Allergies (food or environmental): anything serious that causes anaphylaxis or urgent treatment
Dietary Restrictions (these are the dietary options that the kitchen can accommodate at camp)
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Health Conditions and/or Medications: anything that we should know about that would aid in your care if there were an emergency or you were unable to communicate
Emergency Contact: provide the name, phone number, and relation of the person you want contacted in case of emergency during camp.
Comments/Questions/Other Info
Thank you!!! We appreciate you submitting your application and your eagerness to serve our campers (oncology patients, survivors, siblings, and bereaved siblings). We will be in touch once our team has assessed our need against your availability.
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