EPIC Summer Camp 2024 | Adult Volunteer Application

Adult Volunteer Information

Full Name

Date of Birth

Gender

Allergies

Special Needs/Dietary Needs

Does you take medications?

If yes, please provide information on medication taken regularly. (Name, Frequency, Dosage, Special Instructions)

Adult T-Shirt Size

Are you a First-Time Camper?

Emergency Contact Information

Emergency Contact 1

Relationship to Adult Volunteer

This address will receive a confirmation email

Phone

Address

Emergency Contact 2

Relationship to Adult Volunteer

This address will receive a confirmation email

Phone

Address

How Did You Hear About Us?

Safety Information

Have you received all the immunizations required by the state of Texas?

Do you have any ANAPHYLACTIC (life threatening) allergies that may require an Epi-Pen, such as medications, foods, bees, etc.

Do you have any orthodontic appliances they will be bringing to camp?

Over-the-counter medications MUST also be in their original container/packaging and will only be given according to label directions and according to age limitations on the label. (For example, over-the-counter Melatonin labeled for "use on ages 12 and older" will NOT be given to children under the age of 12. By typing my name below, I acknowledge this statement.

Stoney Creek may use the following over-the-counter remedies on campers as deemed necessary by the nurse: Triple Antibiotic Ointment, Aloe Vera gel, Sting Relief, Anti-Itch cream, and cough drops. Additional over-the-counter medications that our Health Centers use as needed are listed below. Please indicate only those that you do NOT give permission for use. BY LEAVING THEM UNMARKED, YOU GIVE PERMISSION FOR USE. Tylenol/Acetaminophen (for pain relief) Motrin/Advil/Ibuprofen (for pain relief) Benadryl/Claritin/Zyrtec (for allergy relief) Cough Syrup an/or throat spray Miralax (for constipation) TUMS (for upset stomach)

You will be directed to the payment portal once you click submit. Thank you for registering for EPIC Summer Camp 2024!

EPIC Summer Camp 2024 | Adult Volunteer Application | Stoney Creek

Description

EPIC Summer Camp 2024 | Adult Volunteer Application | Stoney Creek

Description

Please Fix the Following