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Fire Prevention
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Burn Survivors
Our Impact
Get Involved
About Us
- Our Mission
- Our Team
- Contact Us
- News
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CBTS Volunteer

Camp Beyond the Scars

Volunteer Application

Camp Beyond the Scars Counselor Application

When: July 8-12, 2024

Where: KOA Chula Vista

Qualifications to be a Volunteer Cabin Counselor or Staff member:
• Be 21 years of age or older
• Energetic, outgoing and friendly
• Ability to remain friendly, positive and respectful in a stressful environment
• Possess effective communication skills that demonstrate appropriate tact and diplomacy
• Patient with children of all ages and abilities
• Comfortable interacting with people you do not know
• Able to handle multiple functions effectively in varying environments

Time Commitment – Volunteer Cabin Counselors and Staff members will be required to remain at camp full time and for the duration of the camp program.

Training – Volunteer Cabin Counselors and Staff members will attend an Orientation and Training. Counselor assignments are not confirmed until the completion of Orientation. Please submit a current Certificate of Completion for Mental Health First Aid or similar if in the medical/mental health field. Mental Health First Aid offers free seminars throughout the year. Visit mhasd.org for more information.

Steps to Become a Volunteer Cabin Counselor or Staff member:
• Complete this online application
• Attend a required Cabin Counselor Interview (applicable to all applicants) to be assigned
• Once application is accepted, conduct a Live Scan screening (applicable to all applicants)
• Attend the necessary training sessions

This application is not a guarantee of your acceptance to be a volunteer with Camp Beyond the Scars. You will be notified once your application has been received and accepted. If you have any questions or concerns about volunteering to be a camp counselor or staff member, please contact Jeaninne at [email protected] or (858) 541-2277. Deadline to apply will be May 15, 2024.

Step 1 of 8

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Volunteer Cabin Counselor & Staff Application
Name*
First Last
Your pronouns
DOB*
Month
Day
Year
Mailing Address*
Street Address City State / Province / Region ZIP / Postal Code
Phone*
Email*
Occupation, if fire station - what department and station?
T-Shirt Size (Unisex)*
- XS
- S
- M
- L
- XL
- XXL

Are you a new or returning volunteer?*
- New
- Returning
Have you ever known or worked with burn survivors before?*
- Yes
- No
- I am a burn survivor
Previous Camp Experience?*
- Yes
- No
Name of camp, position, and dates*
How do you feel your participation will benefit the camp program?*
List experience you have working with children, if any.*
Please list any second language you speak.
Do you have any special skills/talents/contributions you would like to bring to Camp Beyond the Scars? ( ABA, ASL, musical instruments, etc.)
List current certificates/licenses and expiration dates. Include CPR/AED, First Aid, Mental Health First Aid.
Hidden
Are you able to attend MANDATORY July 9, 2023 orientation?
- Yes
- No
Hidden
What age group would you prefer to work with?*
- 8-10
- 11-12
- 13-14
- 15-17
Hidden
We will need counselors to lead activities during the week.*
- I can lead activities
- I cannot lead activities
Burn Survivor Applicant
Skip the next question if you are not a burn survivor.
We welcome burn survivors to volunteer, but respectfully request you share about your personal experience. Please describe your burn experience

Health
Please answer the following questions honestly and to the best of your knowledge. Your personal information will only be divulged to staff and professionals who need to know of medial situations for your safety and the safe conducting of camp activities. By filling this application, you agree that you have fully disclosed any health or medical conditions. If questions do not apply, please skip.
Do you have any dietary restrictions and/or allergies?
Name of Health Insurance
Primary Care Physician (PCP)*
PCP phone number*
Do you have any medical/mental/emotional conditions that would hamper your ability to perform the essential functions of the job of Volunteer Cabin Counselor?
List any current and/or over the counter medications you will be taking at camp
Have you received your COVID 19 vaccination?*
- Yes
- No
Please list the dates of the 1st and 2nd vaccination (and booster if applicable)
Name of Emergency Contact
First Last
Phone*
Relationship to you*
Personal References (For New Counselors Only)
Provide two (2) contacts you are not related to who have knowledge of your character, experience, and ability. Skip this section if you are a returning counselor.
Reference 1 Name
First Last
Phone
Email
Reference 2 Name
First Last
Phone
Email

Criminal Background History and Authorization to Investigate
Have you ever been convicted, fined, place on probation or imprisoned of any crime?*
- Yes
- No
I UNDERSTAND THAT:
I understand that the Burn Institute will conduct DOJ, FBI and National Sex Offender background checks. I understand that if circumstances are discovered that would indicate a 'yes' answer to the above question, consideration to participate may be terminated immediately. I understand that camp may terminate my participation if found, regardless of when discovered, to have any of the following: - history of complaints of abuse or neglect towards a minor - resigned, terminated, or asked to resign from a position, paid or unpaid, due to complaint(s) of sexual abuse of a minor - falsified or omitted information in this disclosure statement. I also understand that untrue, misleading, or omitted information herein or in other documents completed by me may result in dismissal, regardless of when discovered, by the camp. I authorize investigation of all statements herein, including any checks of criminal records, and release the camp and all others from liability in connection with the same.
Initial if you agree with the above statement

Photo/Video/Publicity Release
I authorize the Burn Institute and it's authorized partners to use photographs, videos, interviews, and artwork taken, created, and/or submitted during Camp Beyond the Scars. This includes any/all camp programs and activities undertaken throughout the week. I permit the Burn Institute and it's authorized partners to use and publish photographs, videos, interviews, and artwork for publicity purposes including Burn Institute publications, activities, literature, fundraising, and/or news media. I agree to hold harmless the Burn Institute, its officers, agents, employees and authorized partners from any liability resulting from or arising in connection with the taking, publication, and/or release of the photographs, videos, interviews, and artwork.
Initial below if you agree with the above statement

Release of Personal Contact Information
The Burn Institute will publish a camp staff roster including the names, email addresses, and phone numbers of those involved in the program to facilitate continued communications among the camp staff. I hereby give permission to the Burn Institute to have my personal contact information released on the camp staff roster.
Initial below if you agree with the above statement

Camp Beyond the Scars Staff Behavioral Agreement and Liability Waiver
Training
All counselors must complete all required training, both online and in person, adhering to all deadlines set by the Camp Director. All counselors must attend the entire scheduled training session(s) held and may not be late for any session.
Drugs, Alcohol, & Tobacco/Vape Use
The use of non-prescription drugs, alcohol, and/or tobacco/vape is strictly prohibited. Possession of alcohol, drugs, chewing tobacco, e-cigarettes, or any products containing tobacco will result in immediate dismissal from camp.
Visitors & Leave
No one is allowed to leave camp without first notifying the Camp Director. If you do leave for an unexcused reason, you will not be permitted to return. Visitors are not allowed on the premises outside of scheduled visitor days and times, without prior approval of the Camp Director.
Curfew
Camp staff will be in bed by 11:00 pm each night to assure that a good night’s sleep is obtained in preparation for the following day’s activities. Camp staff will sleep in their assigned cabins every night.
Clothing
Counselors must follow the guidelines for “dress code”. These guidelines include items such as two-piece bathing suits or short shorts. Camp shirts must be worn at all times while at camp. Flip-flops, open-toed shoes or bare feet are unacceptable around camp grounds (with exception of pool area).
Conduct
Counselors must follow the guidelines for “staff conduct”. Any behavior that displays negative role modeling and may be construed as detrimental to the camp’s integrity will not be tolerated and will be grounds for dismissal.
Medications
All medications (over-the-counter and prescription) must be turned over to the Camp Nurse upon arrival and will be stored under lock and key. There should no medications that are accessible to the campers that are not being dispensed by the Camp Nurse.
Leadership
All rules and directives issued by the Camp Director must be supported.
All camp counselors and staff will be responsible for adhering to all rules and regulations as outlined in the Camp Beyond the Scars Handbook and as indicated above.
Liability Agreement
I understand that the position as a Counselor at Camp Beyond the Scars camp is non-compensated and involves working twenty-four hours a day for the duration of the position. I further realize that camp, by nature, is a physically strenuous activity. Injuries and exposure to cold temperature are potential dangers. Proper clothing and equipment are required. I further acknowledge that potential injuries include strains, sprains, cuts, abrasion, broken limbs, and even accidental death. I hereby Release, Waive, Discharge and Covenant Not to Sue or hold the Burn Institute and its employees, volunteers, partnering organizations and agents responsible or liable, and I will assume full responsibility, on or off premises for any injuries or damages incurred or caused by me in connection with my stay during Camp Beyond the Scars camp. The Burn Institute reserves the right to release any volunteer due to lack of campers, or if behavior of the volunteer is, in the sole judgment of the Camp Management Team, determined to be detrimental to the best interest of the children, adults using the facilities and/or the overall welfare of the camp program.
Initial below if you agree to abide with the above staff behavior & liability agreement:

THANK YOU!
Thank you for applying to Camp Beyond the Scars! We will be reviewing applications and you should anticipate hearing from us within the next month. All volunteer counselor applicants will be interviewed prior to being assigned to the camp team. If you have any questions, please contact Carlos Olivares at [email protected].

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San Diego, CA

8825 Aero Drive, Suite 200
San Diego, CA 92123

P. (858) 541-2277

Imperial Valley, CA

612 J Street, Suite 3
Imperial, CA 92251

P. (760) 355-3175

F. (760) 355-0836

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