2025 Glenn County 4-H Camp Adult Volunteer Staff Application

First Name ✻

Last Name ✻

Phone Number ✻

Email Address ✻

Street Address ✻

City ✻

Zip Code ✻

Age ✻

Gender ✻

T-Shirt Size for Camp ✻

V-Neck Women's Shirt Option (additional $10 fee)

Are you currently an Approved 4-H Adult Volunteer? ✻

County ✻

In case of an emergency, please contact (Insert Name) ✻

Relationship ✻

Phone Number ✻

Have you attended Glenn County 4-H Camp as an Adult Volunteer in previous years? ✻

Have you previously attended camp as a camper, Teen Camp Counselor, or Adult Staff? ✻

Adventure/Challenge: challenge/rope course, climbing, rappelling, and/or spelunking/caving. ✻

Arts and Crafts: ceramics/pottery, drawing/painting, leather craft, metal work, photography, woodworking, tie dye, and/or crafts. ✻

Campcraft/Pioneering; Backpacking, campcraft, hiking, mapping/geocaching, outdoor cooking, outdoor living skills, overnights, and/or wilderness trips. ✻

Dance ✻

Drama ✻

Music: singing or instruments. ✻

Nature: animals/animal care, astronomy, birds, environmental studies, flowers, forestry, insects, rocks/minerals, and/or weather. ✻

Sports/Fitness: aerobics/exercise, archery, baseball/softball, basketball, biking, fishing, football, golf, gymnastics, hockey, informal games, yoga, rifle, skating, soccer, snow sports, tennis, track and field, volleyball, dummy roping, and/or wrestling. ✻

Miscellaneous: academics, aviation, community service, farming/ranching, gardening, foreign language, leadership development, radio/TV/video, storytelling, and/or team building. ✻

Will you be able to stay, for the duration of camp (Wednesday, June 18, 2025 - Sunday, June 22, 2025)?  ✻

Adult Volunteers have the option to stay in the Cabin/Dorm or apply for a Trailer/RV space. Please be aware, there is limited space for trailers at Camp Tehama. Please choose the overnight sleeping arrangement that you will be requesting. To complete the Trailer/RV Application, please visit: https://ucanr.edu/sites/glenn/files/395442.pdf. The link will also be provided on the survey post page. ✻

Adult Volunteer commitment statement: I will commit to understanding the requirements and responsibilities of being a good Adult Volunteer. I will commit to completing all the training and being at 4-H Camp each day for my assigned camp session. I understand that being a 4-H Camp Adult Volunteer is a huge responsibility, and I will be attending camp as a role model for our Teen Camp Counselors and campers. I am willing and able to give of myself to help them grow and develop and enjoy 4-H camp. I submit that all information on this application is true and complete. I have read and understand the role and description of an adult volunteer and will abide by the practices set forth by the Glenn County 4-H Camp Committee. I understand that if I do not meet the standards of a responsible adult volunteer, I will be dismissed from my duties. This role and description are not intended to be all-inclusive.

By placing my initials in the box provided, I'm committed to participating in the 4-H Camp Planning process and attending at least 2 of the scheduled planning meetings and the mandatory training meeting requirements. If I can't make a meeting or need to make arrangements, I will notify our Camp Director, Maddie Coleman, at (530) 774-7078 and make arrangements. I understand there may be a planning meeting on the weekend, and our Camp Director will work with us to find a time that works best.

  ✻

By placing my initials in the box provided, I agree to upload or turn in the Health History Form and the Adult Camp Staff Camp Rules by the deadline of Monday, May 5, 2025. The "upload" option is at the top of the survey to turn these forms in electronically. The link to the Health History and Authorization form is accessible at the bottom of the survey. This form can be dropped off at the UCCE Office located at 821 E. South St., Orland, or can be emailed to glenncounty4h@ucanr.edu, by the deadline.    ✻

Are there any special accommodations needed?  ✻

Adult Volunteer Glenn County 4-H Camp Registration Fee (Adult Fee is $50.00. There is a $2.00 service fee added per adult when paying by credit card.) You will need to complete a new survey for each adult you are signing up. ✻