VOLUNTEER- Camp Limberlimbs Application

Thank you for your interest in volunteering at Camp Limberlimbs on September 23-25, 2016 in

Gold Creek, MT. Please contact Katie Levine at klevine@arthritis.org or 406.203.3019 with any questions.

Volunteer Profile

First Name *

Nick Name

Last Name *

Gender *

Date of Birth (MM/DD/YY) *

Age at event *

T-Shirt Size *

Street Address *

P.O. Box/Apt #

City *

State *

Zip *

Email Address *

Cell Phone *

Home Phone

Employer (if applicable)

Work Phone (if applicable)

What type of volunteer position are you seeking? *

Counselor or Junior Counselor

Medical Team Member (must be licensed health care professional)

Activity Specialist

Other Volunteer (photographer, check-in, A/V support, runner, etc) Other Volunteer (photographer, check-in, A/V support, runner, etc)

Emergency Contact

Emergency Contact 1

First Name *

Last Name *

Relationship to Applicant *

Street Address *

P.O. Box/Apt #

City *

State *

Zip *

Email *

Cell Phone *

Home Phone

Emergency Contact 2

First Name

Last Name

Relationship to Applicant

Street Address

P.O. Box/Apt #

City

State

Zip

Cell Phone

Home Phone

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