Spinal Cord Injury (SCI) Camp September 15, 2022
At this time we are only accepting submissions from volunteers with a RN/LPN/PCA/CNA background
I am 18 years of age or olderI am between 13 and 17. I will be supervised by my parent or guardian for the duration of the camp weekend
Gender —Please choose an option—FM
Home Phone Number
Mobile Phone Number
List type of professional license held* : OTPTRNCNAMDStudentOther
Please initial if you will attend the weekend camp from Thursday afternoon until Sunday at noon:
We would like to accommodate you if we can so please let us know if you will require a late check-in or early check-out time.
How did you hear about Camp With A Ramp?
SCI and Volunteer Experience:
Do you have experience working with individuals with Spinal Cord Injuries?
Please give a brief description of your experience with Spinal Cord Injuries, your hobbies, interests, and areas of expertise; what you feel you can contribute to the camp weekend:
Please check the areas you are interested in volunteering:
Animal interactionTherapeutic RidingArts and craftsSportsFishingSunrise HikesDirecting to cabins/activitiesPlanning/CoordinatingMedical CarePicture DVDCheck in/outClean upClericalLuggage assistanceEducationFish HatcheryTransfersPersonal careMovie nightGamesTransportation
Would you be willing to bring other individuals luggage in your vehicle to the camp weekend?—Please choose an option—YesNo
Would you be willing to give others a ride to the camp weekend in your vehicle? —Please choose an option—YesNo
Do you have any additional special considerations?
Do you have any of the following conditions?
History of heat related illness —Please choose an option—YesNo
Cardiovascular disease —Please choose an option—YesNo
Asthma or other respiratory problems —Please choose an option—YesNo
Are you hypersensitive to insect stings? —Please choose an option—YesNo
Do you have a condition that might be affected by volunteering for this weekend camp (i.e. heat sensitivity, change in altitude, etc.) —Please choose an option—YesNo (If yes, please explain):
List any allergies:
List any special dietary needs/restrictions:
Emergency contact 1* :
Phone number* :
Emergency contact 2:
Tee shirt size (select one) —Please choose an option—SMLXLXXLXXXL
How do you prefer to be contacted? —Please choose an option—phoneemail
You will be contacted shortly with information on a mandatory volunteer orientation meeting. Please feel free to email us with any questions or concerns.