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Youth Volunteer Leadership Program Application

Thank you for your interest in volunteering for summer camps with the Township of Wilmot!

Please ensure you have read and understand the expectations of becoming a Camp Volunteer with the Township of Wilmot.

All applicants must be 13 to 19 years of age. (Must have completed Grade 7)
Priority will be given to volunteers who are available for more than one week

Volunteer Release

By completing and submitting this form I hereby apply to Township of Wilmot to serve as day camp volunteer. I certify that all of the information provided by me on this form is correct and true.

I understand that the act of applying does not guarantee a volunteer position and that the Township of Wilmot reserves the right to decline an application for any reason.

Volunteer Information

First Name

Last Name

Address

City

Postal Code

Primary Phone Number

Alternate Phone Number

Email Address

Age

Birth Date

Health Card Number

Doctor's Name

Doctor's Phone Number

Please list any health or learning concerns we should be made aware of.

Availability

Please select the camp weeks that you are available.

July 3-7

July 10-17

July 17-21

July 24-28

July 31-August 4

August 8-11

August 14-18

August 21-25

August 28-September 1

Tell us why you want to volunteer for summer camp.

Emergency Contact Information

First and Last Name

Phone Number

Relationship

First and Last Name

Phone Number

Relationship

Parent/Guardian Information

First Name

Last Name

Address

City

Postal Code

Primary Phone Number

Work Phone Number

Email Address

Parent/Guardian Consent

I, the parent/guardian of the applicant, certify that all information contained within this application is truthful and accurate, and that I understand what my youth is applying for.

First and Last Name

Parent/guardian signature

Clear

Any personal information that is collected is done in accordance with Sections 27, 28, 29 and 30 of the Municipal Freedom of Information and Protection of Privacy Act (MFIPPA) and will be used to contact you concerning the information you provided regarding the Youth Volunteer Leadership Program Application. Questions about this collection should be directed to:

Director of Community Services
Township of Wilmot, Administrative Complex
60 Snyder's Road West
Baden, Ontario N3A 1A1
519-634-8444
communications@wilmot.ca

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