Camp Escapades 2025 Volunteer Application Form

Camp Escapades is a popular youth volunteer activity in South Bay. Volunteers return yearly to become a "white shirt" and serve as a camper's buddy or specialized activities team member. This is an enjoyable and rewarding opportunity for volunteers, typically students 14 years of age and over. An orientation is provided to volunteers to give them an idea of what to expect at Camp Escapades. The volunteers enjoy a meaningful experience that gives back to the community and have opportunities to develop better leadership and social skills. Many youth volunteers come from South Bay high schools, volunteer organizations, and local colleges and universities.

Camp Escapades offers a traditional summer camp experience to children in the community that is inclusive of everyone's needs. The camp team is comprised of highly trained pediatric occupational therapists from Momentum with numerous years of camp experience who oversee programming, staff, and volunteers. Camp groups are staffed with occupational, physical, or speech therapists, paraprofessional educators, and one-on-one teen volunteers who serve as the child's "buddies" throughout the week. The camp activities occur in a safe, encouraging environment and are adapted to ensure every camper can have fun, regardless of age or ability.

Volunteer Hours:

Monday, Wednesday, Thursday 8:45am-2:00pm

Tuesday, Friday: 8:45am-2:30pm

Volunteer Weeks:

WEEK 1: July 14-18

WEEK 2: July 21-25

WEEK 3: July 28-Aug 1

WEEK 4: Aug 4-8

Volunteer Orientation (Day 1):

Monday, June 30th from 3:00-6:00pm

All Staff and Volunteer Orientation (Day 2):

Monday, July 7th from 5:00-7:00pm

"White Shirt" volunteers can sign up to volunteer for one week or up to all four weeks. An email will be sent out, within 1-2 weeks of receiving the application, to confirm which weeks you have been accepted as a volunteer. If you are interested in volunteering but are unable to commit to a full week, please contact campescapades@momentum4all.org for more information!

Admission process

Please complete the application form in its entirety and submit all required paperwork. AFTER you have been notified of acceptance, you will be required to do the following by June 20th in order to maintain your volunteer position:

Provide proof of a valid tuberculosis (TB) test from within 1 year
Live Scan Fingerprinting (if over the age of 18)
Proof of vaccination for COVID-19 is recommended but not required

Please contact syates@momentum4all.org if you have any questions.

Volunteer First and Last Name*

Volunteer Date of Birth:*

What is your preferred language?*

Volunteer Address: *

Please provide full address, including Street Number, Street Name, Apartment Number, City, State and Zip Code

Volunteer Email:*

Volunteer Cell Phone:*

Phone

Volunteer Shirt Size:*

Select

Would you like to purchase an additional shirt?*

Select

Allergies:*

Select

If yes, please list allergies:*

Medical Conditions*

Select

If yes, please list conditions: *

Do you require any accommodations?*

Select

If yes, please list accommodations: *

Are you over 18 years old?*

Select

Parent Contact First and Last Name:*

Parent Email Address:*

Parent Phone Number:*

Phone

Relationship:*

Emergency Contact First and Last Name:*

Relationship to Volunteer:*

Emergency Contact Phone Number:*

Phone

What is your level of education?*

Current High School/College/ University *

Will you need a parking pass?*

Select

Volunteer Experience

Have you attended Camp Escapades before?*

Select

If you attended Camp before, when?

Have you volunteered with Momentum or PTN before?*

Select

If you volunteered( not camp) what was it for? *

Why do you want to volunteer with Camp Escapades?*

Please describe any other volunteer experiences:*

Not with our facility

Are you from a community volunteer organization?*

Select

Other Volunteer Org

What would you like for us to know about you?*

Do you have experience working with children? *

Please list, where, when, and in what capacity

Have you worked with children with disabilities?*

Please list, where, when, and in what capacity

When are you available to volunteer?*

Please select all that apply.

Select

What is your 1st choice for volunteer position?*

Please note we will try our best to accomodate your preference

Select

Volunteer Medical Insurance Information

Medical Insurance Information*

Insurance Provider (Kaiser, Optum, etc.)

Primary PCP Name and Phone Number*

Consents

General Photo Consents

Momentum INTERNAL Materials*

Permission to use on all Momentum Internal Materials that are designed to be accessed by staff members, board members, people supported by Momentum and their families. This includes staff newsletters, presentation materials used for board presentations and staff meetings, private family galleries, Momentum Family Forum (via Mighty Networks), Playground Communication App, internal bulletin boards, training materials, etc.

I GIVE permission

I DO NOT give permission

Momentum EXTERNAL Materials*

Permission to use on all Momentum External Platforms that are designed to be accessed by the public. The photo/story/video information may be disseminated widely through various means. These include, but are not limited to, social media sites, blogs, websites, newsletters, brochures, events promotions, fundraising materials etc.

I GIVE permission

I DO NOT give permission

Consent for Emergency Medical Treatment*

In case of an emergency and if I am not present and cannot be contacted at the telephone numbers on my child's parent information form, I understand that in the event of a medical emergency, Momentum will call 911 or other appropriate medical personnel. If an ambulance must transport my child, I understand that it will take my child to the closest medical facility available.

I give permission to the personnel of Momentum to consent to any x-ray examination, anesthesia, medical or surgical treatment, and/or other emergency medical care advised by a licensed physician or dentist and rendered under the provisions of the Medical or Dental Practice Act. I understand that Momentum will not be liable for any first aid treatment, medical or hospital care, medications or surgical procedures rendered pursuant to this consent.

I GIVE permission

I DO NOT give permission

Next Steps

Following submission of your application, you (over 18) or your parent (under 18) will receive a DocuSign email with our consent forms. These forms are required in order for your application to be completed.

Should you not receive the email, please check your junk mail. You will have 7 days to complete the consent forms.

Send me a copy of my responses

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