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					                                 Camp Opehay
              Volunteer Counselor & Staff Application
   Thank you for your interest in volunteering at Camp Opehay August 8-11th!


Full Name:
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Gender (please circle): Male or Female
Date of birth_____/_____/_____ Age: ______
Drivers License #:
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Email Address:
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Current mailing address and zip code:
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Address if different than mailing address:
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Home phone number:
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Cell phone number:
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What time, day, and phone number are best to reach you by?
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How did you hear about Camp Opehay?
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Please share with us why you are interested in volunteering for Camp Opehay?
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             A Collaboration between Stanford University’s Pediatric Bipolar Disorders Program   1
                                                   &
                             Youth Bipolar Foundation of Northern California
Please share with us your experience or knowledge of pediatric bipolar disorder.
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If selected as a volunteer would you be willing to attend a four hour training session in June on a
Saturday or Sunday? If you are not willing or able to attend a training session please share why.
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                                              Education
Please list:
 Education         Name, City, State          Date of         Highest            Degree/Major
                                            attendance         grade
                                                             completed
High School

College

Post
Graduate


                                    Professional Licensure
Do you hold any type of professional licensure? If yes, please list and attach a copy of your license.
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                                     Employment History
Please list present employer, and job title:
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Employer’s address:
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Supervisor’s name:
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               A Collaboration between Stanford University’s Pediatric Bipolar Disorders Program     2
                                                     &
                               Youth Bipolar Foundation of Northern California
May we contact your supervisor?
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Phone Number:
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If you do not wish for us to contact your supervisor, whom may we contact at your place of
employment?
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Phone Number:
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 Please attach your resume, or last 5 years of employment history

                                        Camp Positions
Please list the volunteer position you are seeking. Volunteer opportunities for August 8-11th, 2008 are
detailed on page 6.
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The campers are divided into four age groups: 9-11, 11-13, 13-15 and 15-17. Do you have a specific
age group, and/or gender, that you would prefer to work with? If yes, please specify and tell us why.
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Placement of counselors and staff is one of our most difficult tasks. We explore a multitude of factors
when volunteer assignments are selected. The final decision is based on what the camp advisory
committee feels is most beneficial to the camp and campers. For this reason we may not be able to
accommodate your preference. Would you be willing to work with a group of campers that might not
be your preference? If not, please explain why you feel this way.
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              A Collaboration between Stanford University’s Pediatric Bipolar Disorders Program           3
                                                    &
                              Youth Bipolar Foundation of Northern California
Camp is from the evening of August 8th until the 11th . Can you be available the entire weekend? This
is most preferred. However, if you are not available please provide the times and dates that you are.
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                                Camp Experience and Skills
Do you have any previous camp experience? If yes, please describe the type of camp, your role and
approximate date.
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Please list any special camp skills you have and whether you would be interested in sharing these skills
while at camp. For example: Arts & Crafts, Musical Instrument, Dance, Yoga, Sports, etc.
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                                           Certification

          Do you currently hold any of the following certificates?

                  Certificate                                 Please specify Yes or No
                      CPR
                      BLS
                    ACLS
                     PALS
                   First Aid
                 Ropes Course
Other: Please specify-

                                         Miscellaneous
Do you have any physical limitations, which would affect your ability to perform your duties? If yes,
please describe in full:
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              A Collaboration between Stanford University’s Pediatric Bipolar Disorders Program        4
                                                    &
                              Youth Bipolar Foundation of Northern California
Have you ever been convicted of a crime other than a traffic offense? If yes, describe in full:
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Have you ever been adjudged liable for civil penalties or damages involving sexual or physical abuse?
If yes, describe in full:
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If you are a parent have your parental rights ever been terminated for reasons involving sexual or
physical abuse? If yes, describe in full:
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                            Background Check Information
For the concern and safety of our campers, Camp Opehay maintains the right to
process a background check on all applicants. The cost of this report is paid for
by Camp Opehay. If you recently had a background check, please attach a copy
of the report. We appreciate your understanding of the importance of this
measure.
Have you ever had a background check with fingerprints done? If yes, please describe in full:
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List two non-family references we may contact:
1.Name: __________________________________ Phone: __________________________________
Relationship:
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2.Name: ___________________________________Phone: __________________________________
Relationship:
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              A Collaboration between Stanford University’s Pediatric Bipolar Disorders Program     5
                                                    &
                              Youth Bipolar Foundation of Northern California
Applicants for all positions at Camp Opehay are chosen without regard to race, color,
religion, gender, sexual orientation, national origin, age, marital or veteran status, or
the presence of non-job-related medical condition/s or disability.

I affirm that the above information is true and complete. I understand that in the
event false information is provided I can be terminated from my position. I
understand that this opportunity is of a volunteer nature and I do not expect Camp
Opehay to provide monetary or any other type of compensation for participating.

Signed: ___________________________________________________________________________

Date: ____________________


Volunteer opportunities available for Camp Opehay, August 8-11th, 2008:
   1. Camp Counselor: In this position you will be a team member under the guidance of a
      Lead Counselor and in a designated cabin hosting 6-8 campers who have bipolar disorder.
      Counselor to camper ratio is anywhere from 1:2-1:4. Your responsibilities will include but are
      not limited to the following: assisting your campers in all activities, encouraging and role
      modeling positive behavioral choices as well as assisting campers in utilizing social skills (in
      some instances this means development of new or forgotten social skills), ensuring the campers
      go to the infirmary for their scheduled medication times, monitoring your campers’ hydration
      and nutrition, overseeing that your campers practice good hygiene while at camp, and
      accounting for your assigned campers at all times for the duration of the camp session. You
      will be sleeping in the same cabin with your assigned campers. A general knowledge, and
      comfort with, pediatric bipolar disorder is essential. We are seeking twenty-four counselors.
   It is important to be aware that counseling at Camp Opehay can be both
   physically and emotionally challenging. It may also include participation in
   strenuous activities, long hours, and possibly little and/or interrupted sleep.
   Therefore, the following personal qualities are important in making the
   weekend successful: patience, compassion, high energy, endurance, a team
   player mentality, including the ability to maintain a positive attitude despite
   any circumstance, flexibility, and a capacity to relate with bipolar children
   and teens.

   2. Lead Cabin Counselor: This team position reports directly to the Clinical Director and
      includes overseeing a cabin of up to 8 campers and accompanying staff. You will help
      implement education, guidance, intervention techniques, and assist your cabin’s campers and
      staff as needed. You will be sleeping in the same cabin with the campers. We are seeking 8
      lead cabin counselors.
   3. Quiet Zone Counselor: This position reports directly to the Clinical Director and includes
      overseeing the necessary and important quiet respite zone for the kids. Frequently (not always)
      this counselor will be a one to one with a child that needs a “break” from the activities.
      Because you will be working with an age range of children of 9 to 17, this position requires you
      to be flexible and have a calm disposition. We are seeking 2 quiet zone counselors.



             A Collaboration between Stanford University’s Pediatric Bipolar Disorders Program       6
                                                   &
                             Youth Bipolar Foundation of Northern California
4. Arts and Crafts Team Member: In this position you will be a team member under the
   guidance of the arts and crafts team leader and will collaborate with the other team members to
   demonstrate to and assist the campers and staff in the production of fun, creative projects
   throughout camp. Your responsibilities also include preparation and clean-up of art projects
   located through out the camp ground. For example, we will have art projects located at the
   swimming pool, ropes course, dining hall, amphitheater, or art yurt. We are seeking 3 arts and
   crafts team members.
5. Arts and Crafts Team Leader: This position reports directly to the Camp Director and
   includes organizing and planning the arts and crafts program at camp. The team leader will
   facilitate in creating a stress-free creative atmosphere for the enjoyment of the campers.
   Additionally, the leader is a resource for the other arts and crafts team members, assists in
   purchasing supplies prior to camp (supplies paid for by Camp Opehay/YBFNC) as well as
   assisting in bringing the arts and crafts supplies to camp. We are seeking 1 arts and crafts team
   leader.
6. Activities Team Member: In this position you will be on a team under the guidance of
   the activities team leader and collaborate with the other team members to demonstrate to and
   assist the campers and staff in physical activities such as soccer, softball, kickball, hiking, etc.
   Your responsibilities also include preparation and clean-up of activities located through out the
   camp ground. For example, we will have activities on the hiking trail, gardens, fields,
   swimming pool, basketball courts, etc. We are seeking 2 activities team members.
7. Activities Team Leader: This position reports directly to the Camp Director, the Taylor
   Family Foundation and YMCA staff and includes the organizing and planning of the physical
   activities program at camp. The team leader will facilitate in creating a stress-free active
   atmosphere for the enjoyment of the campers. Additionally, the leader is a resource for the
   other activities team members, assists in purchasing of supplies, and obtains them prior to
   camp. We are seeking 1 activities team leader.
8.   Camp Aide: In this position you will be on a team under the guidance of the Camp Director.
     This position requires flexibility and positive energy because you are the glue that makes this
     camp happen. The team will be asked to assist in different areas through out the camp.
     Examples include: assisting in registration and departure of campers, working alongside the
     YMCA lifeguards supervising the pool deck and deck activities, helping to prepare the dining
     hall before meals and clean up afterwards, bathroom monitor during a meal time, physical
     activities assistant, or arts and craft assistant for a particular project. This is a busy and vital
     team position. We are seeking up to 6 camp aides.
9. Camp Nurse: In this position you will be on a team under the guidance of the Infirmary
   Directors and responsible throughout the camp session to assist the medical staff in the
   following situations: dispensing daily medication for camper’s, and providing minor first aid to
   campers and staff. You must possess a current R.N. or L.V.N. license for the state of California
   and be knowledgeable regarding psychotropic medications and pediatric bipolar disorder. Our
   nursing staff will total up to 6 nurses. We are seeking 2 nurses.




            A Collaboration between Stanford University’s Pediatric Bipolar Disorders Program           7
                                                  &
                            Youth Bipolar Foundation of Northern California
             Thank you for your interest in Camp Opehay.

Camp Opehay can be a life changing and profound experience for
both campers and staff. This unique camp experience offers
understanding, healing, and acceptance to youth with bipolar
disorder on a level that is unparalleled to any other. For most
Opehay campers it ignites courage, confidence, and a willingness to
acknowledge and understand more comprehensively their brain
disorder. Subsequently, the healing that these children and teens so
desperately long for begins!

  We sincerely look forward to hearing from you.

 Please submit your completed application via email:
                  camp.opehay.rocks@gmail.com
                       Attn: Meghan Howe
             If you cannot submit via email please send to:
      Camp Opehay/YBFNC, PO Box 2009, Walnut Creek, CA 94595




       A Collaboration between Stanford University’s Pediatric Bipolar Disorders Program   8
                                             &
                       Youth Bipolar Foundation of Northern California

				
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