TEAAM: Together Enhancing Autism Awareness in Mississippi

Volunteers

Being a Kamp Counselor at Kamp Kaleidoscope is the coolest way to spend a few weeks of your summer.  If you are willing to work hard, learn a lot, and have tons of fun, we need you!  Many of our Kounselors come back year after year to volunteer and to catch up with their past campers and counselor friends. 

 If you are interested in being a Kamp Kaleidoscope Kounselor next summer, please fill in the information on the form, and then click on the "Submit Information" button and someone will contact you.

 

I want to help with:

Identifying Information:

Gender:

For your employer:

For your Parent or Guardian:

For your Emergency Contact:

Personal Information:

Do you have any chronic health conditions:
Do you smoke?

(Counselors will not be allowed to smoke in cabins or around campers)

Health Care Information:

* All counselors must have insurance coverage. Please send copies of insurance coverage card.

Experience:

Certifications / Talents:

Do you play a musical instrament?

References

List two persons (not relatives) who have knowledge of your qualifications:

SR. COUNSELORS:

I understand I will be expected to attend Kamp Kaleidoscope, without leaving, for the session(s) for which I am chosen.  I further understand that by submitting this form over the Internet, I am giving Kamp Kaleidoscope staff permission to conduct a background check prior to my participation.

JR. COUNSELORS:

I you are under 21 years of age, this form must be submitted by your parent or guardian.

I hereby give consent for the person named in this form to be treated by the Kamp Kaleidoscope medical staff if the occasion should arrise.  I also give consent for him/her to be admittted to the hospital if an emergency should occur, allthough I understand that I will be notified as soon as possible.