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 medical 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.

Please notify a Burn Institute staff member if you are currently using more than 3 medications.

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 any of the above questions, 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.

I authorize the Burn Institute and 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 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.

This Behavioral Agreement has been developed to protect Camp Beyond the Scars, its participants, and the Burn Institute. All camp participants must understand and adhere to the following policies and procedures. Any camp participants who are in violation of these standards may be subject to dismissal and not allowed to attend future camps. We value our participants and require exceptional representation and positive leaders for our campers. TRAINING - I will attend all mandatory training sessions held before camp. VISITORS & LEAVE - I understand that nobody is allowed to leave camp without first notifying the camp director. - I understand that if I leave for an unexcused reason, I will not be permitted to return. - I understand that visitors are not allowed on the premises without prior approval of the camp director. PETS - I understand that personal pets, excluding service dogs, are not allowed in camp. CURFEW - I will be in bed by 11pm each night in order to obtain a good night's sleep in preparation for the following day's activities. - I will sleep in my assigned cabin every night. DRUGS & ALCOHOL - I will not possess or use non-prescription drugs, tobacco, alcohol, or any other illegal substance in the presence of any camper under the age of 21 (including Leaders-In-Training) during the duration of camp. - I understand that possession and use thereof will result in immediate dismissal. MEDICATION - I will turn in all over-the-counter and prescription medications to the camp nurse upon arrival and understand it will be stored and locked. -I understand that medications will only be dispensed under the direction of medical staff. CLOTHING - I understand that clothing with wording, graphics, or designs that might be construed as negative or offensive is prohibited. - I will practice good personal hygiene and dress neat and clean. ELECTRONIC DEVICES - I understand that camp discourages the use of any and all electronic media. PRIVACY - I will not touch other people's property without their permission. - I will not attempt to keep in touch and/or meet with campers (ages 8-17) outside of camp without prior notification approved from Burn Institute Executive Director. - I will not accept campers (ages 8-17) as 'friends' or 'contacts' on any web-based profile sites or social media applications. - I will not post images or videos of camp that includes campers (ages 8-17) on web-based profile sites or social media applications without approval from Burn Institute Executive Director. LEADERSHIP - I will support all rules and directives issued by the camp director and staff. - I understand that behavior that displays negative role modeling and may be construed as detrimental to the camp's integrity will not be tolerated and be grounds for dismissal. - I will be responsible for adhering to all rules and regulations approved by the camp committee and outlined in the Camp Beyond the Scars Policy and Procedures Manual. VOLUNTEER POSITION - I understand that my volunteer position is at-will and non-compensated unless there is an agreement or law that alters that status - I understand that participating in camp involves working twenty-four (24) hours a day - I understand that by nature, camp is physically and mentally strenuous - I understand that the Burn Institute has the right to release any volunteer because of lack of campers - I understand that the Burn Institute has the right to release me if my behavior is determined, by the sole judgement of the camp director and staff, to be detrimental to the best interest and welfare of other camp participants and the facility - I will hold the Burn Institute harmless for any claim resulting from participation at camp