Special Needs Volunteer Form Name* First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Phone*Email* Enter Email Confirm Email Age*Gender* Male Female What areas do you wish to serve?*What is expected of a “Camp Sports Buddy”? • We are hoping that Camp Sports Buddies can be present to partner with their child for all hours of the camp. If you are unable to serve all 5 days, you will still be considered, if we are able to find another individual to partner with you. It is our hope that buddies will have consistent attendance so that the kids will have an opportunity to build a trusted relationship with their assigned buddy. • Camp Sports Buddies will be expected to punctually greet their child each morning, partner with him/her throughout all hours of the camp, as well as make sure they are delivered to their parents at the end of the camp day. • Buddies will be supervised by a trained licensed professional Occupational, Physical or Speech Therapist from K.I.D.S Therapy Associates, Inc., who will assist with making appropriate modifications and adaptations for your specific child. • Buddies will be expected to assist their child with learning new sport’s skills, which may include modeling and participation in the sport. Buddies will also be expected to use and implement any supports that have been recommended by the OT, PT or SLP supervising your child. Supports recommended will be possible positioning techniques, visual schedules or use of assistive technology to assist with communication and behavioral organization. • Camp Sports Buddies will also be responsible for taking their child to the break area (where professional staff will be available to facilitate physical rest or emotional regulation breaks), as well as taking their child to the restroom when needed. All children attending this camp will be toilet trained. What is expected of a “Materials Volunteer”? • Materials Volunteers will be needed in the months of May, June and July before the camp begins to help us fabricate visual supports and prepare craft materials for break times at the camp. Volunteers who volunteer for this will need to help with cutting, pasting, laminating, sewing and other similar jobs. Camp Sports Buddy Materials Volunteer Are you available Monday through Friday from 7:45-11:15 during the week of Aug 6th - Aug 10th?* Yes No Please let us know when you are available to serve during the week of Aug 6th - Aug 10th.* Have you ever worked with a child or adult who has special needs?* Yes No Do you have any physical limitations that would prevent you from running or participating in the sport / modeling skills with a child?* Yes No Please explain your physical limitations* All Camp Sports Buddies must attend a 90-minute training. Specific dates will be announced at a later time. Will you make yourself available to attend one of these trainings?* Yes No Have you served in Kids Therapy sports programs in previous years? Yes No If you wish to volunteer as a Camp Sports Buddy, please list a name and phone number of one personal reference (18 or older) that we may call: Will you need a signed letter from us verifying that you have provided these volunteer hours for the OBCF Soccer Camp (for high school class credit, admission to a professional graduate school, or other)?* Yes No please let us know the name and title that you prefer the letter be addressed to* All volunteers who are 18 and older, must have a background check. We will provide you with the background check form. There will be no cost to the volunteer for the background check fee.Thank you for volunteering to assist with making this a positive, safe, and valued experience for every child attending this camp. You are very much appreciated! Δ