Your Contact Information First Name * Last Name * Birth Date * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year19241925192619271928192919301931193219331934193519361937193819391940194119421943194419451946194719481949195019511952195319541955195619571958195919601961196219631964196519661967196819691970197119721973197419751976197719781979198019811982198319841985198619871988198919901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012201320142015201620172018201920202021202220232024 You must be 15 years of age (17 for Teen Camp) or older to volunteer at Camp NeeKauNis. Street Address * City * Postal Code * State/Province * Phone Number * Phone Number 2 Email * Part A. Camp Program and Position Camp Program(s) * Camp program or programs for which you are applying. Please see the Camp Program schedule. Positions * Camp Director Program Staff Senior Lifeguard Junior Lifeguard Boat Caretaker Head Cook Kitchen Staff Childcare Choreperson Cabin Leader Maintenance Worker Friendly Adult Presence Positions for which you are applying. You can apply for more than one. Training and ExperienceTell us about your training and experience relevant to the above position(s).Please note:Senior Lifeguards must have full NLS Certification.Junior Lifeguards must have at least Bronze Cross.Boating Certification is strongly advised for all waterfront staff.Head Cook must have current Food Handlers Certification.First aid training is an asset.Please list any additional training that may be relevant. Your Training and Experience * Please read the notes above about what to include here. Part B. References Do you attend a Quaker Meeting or Worship group? * Yes No Name of Meeting or Worship group * If yes, which one. Name and contact of referee * If yes, please ask your clerk, recording clerk, or treasurer to be your referee, and give name and best contact phone number and email here. Other reference * If you are not involved in a Meeting, please give one reference from an institution that knows your work or skills: with children, trades, or other areas of specialty and that is not a personal reference. Please provide a name and contact information (email and phone number). Are you a returning volunteer? * Yes No Camp Directors or members of the Camp NeeKauNis Committee * Please give the names of Camp Directors or members of the Camp NeeKauNis Committee with whom you have worked. Personal Reference * Please give the names and contact information (email and phone number) for two people who have known you for more than two years. Part C. Police Records Checks You need a Police Records Check (also known as a Vulnerable Sector Check) if you will be 18 or older when you are on staff and in a position of authority or working directly with vulnerable persons.A vulnerable person is defined as a person who, because of their age, disability, or other circumstances, whether temporary or permanent, are (a) in a position of dependence on others or (b) are otherwise at a greater risk than the general population of being harmed by a person in a position or authority or trust relative to them. (Ottawa Police Services). This requirement pertains to:DirectorsCooksSenior Lifeguards; any lifeguards over the age of 18Cabin counsellors, kitchen staff, and program staff over the age of 18Please contact your local police service for details. The police check belongs to you.In the City of Toronto, you will require a code from Camp to proceed. Please contact neekaunis-recruiting@quaker.ca for this waiver and other instructions.Email a copy to neekaunis.recruiting@gmail.com and your director. If you have submitted a copy of your police check in a prior year, let your director know. If you have a PRC done within the last two years for another purpose, scan and send to the email given above. Part D. AgreementsCamp Neekaunis AgreementCamp NeeKauNis agrees to the following. Camp NeeKauNis will provide a safe working environment for paid and volunteer staff and campers through its published policies and within the regulations of the Province of Ontario.Any personal information obtained from your referees or through a Vulnerable Sector Police Check will be held in confidence.Camp NeeKauNis will safeguard your files amd retain only personal information relating to your service: name, contact information, and date of service.Camp NeeKauNis will provide training for tasks and policies. We value you and your service to Camp NeeKauNis. Volunteer and StaffBy checking the box below, you agree to the following statements. I have read the policies and procedures of Camp NeeKauNis.I understand that after being accepted as staff, I will receive a link to the On-Line Staff Training Module and will complete it.I agree to abide by the policies and procedures of Camp NeeKauNis while I am present at Camp. Camp NeeKauNis will provide training and review sessions as needed and I will attend them. The time of these sessions will be arranged by Camp Committee and the session Director(s).I will respect the privacy of staff and campers and will not engage in wilful gossip that could harm their integrity or the integrity of Camp. When there is a need to report acts of bullying and harassment or deliberate damage, illicit drug or alcohol use, sexual or physical abuse, I understand that I must report and will be given options to whom to report. Camp will follow-up on any report according to its policies, CYM policies and the laws of the Province of Ontario. I am aware that there are sending home consequences to some Camp policies.I will not be alone with any camper under the age of 18 without a second person present or in clear view of others. I will provide supervision for person(s) without police checks who may be working with campers when asked by the Director. Your agreement to the above * Yes No Part E. Signature Today's Date * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20222023202420252026 Your Signature With my signature, I give permission for Camp NeeKauNis to contact my references in Part B above. Signer Name * Parent or Guardian SignatureIf you are under 18, a parent or guardian must sign here. Parent or Guardian Signature For "Title", please enter the relationship to the applicant. Signer Name Signer Title
