2026 Alameda County 4-H Summer Camp Chaperone Application

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2026 Alameda County 4-H

Summer Camp

Chaperone & Adult Volunteer Application

May 29-June 1, 2026

Happy Valley Conference Center

Santa Cruz, California

Chaperone Eligibility

To be a Camp Chaperone, you must:

Be 25 years of age by December 31, 2025
Be a certified 4-H volunteer. Complete the enrollment process required to be a certified 4-H volunteer. If you are not currently enrolled as a 4-H volunteer and active in ZSuite, you must complete all of the NEW volunteer steps linked here.

Note: Chaperones will pay a reduced fee of $100 towards lodging and food costs.

Camp Chaperone Application Process

Complete the chaperone Application and be selected.
Complete the UC CA State 4-H Overnight Chaperone training (Bi-annually)
Complete the online training for First Aid and CPR. (Bi-annually) You do not need to buy the card, please send a screen shot of the page that says, "Congratulations, you passed."
Send confirmation of training to tdaly@ucanr.edu.
All Adult Volunteers must adhere to the Adult Volunteer Code of Conduct.

✻ = Required

2026 Alameda County 4-H Summer Camp

ADULT Chaperone Application

Please use this application to indicate your interest in participating

as an adult chaperone for the 2026 Alameda 4-H Summer Camp.

Applications will be held open until all chaperone positions are filled,

but will close no later than May 15, 2026.

What adult position are you applying for? ✻

Adult Camp Staff ages 18-20 Adult Volunteer - ages 21 - 24 Adult Overnight Chaperone - ages 25 and up Adult Day Chaperone Only, 21 and up Adult Volunteer - ages 21 - 24

Last Name: ✻

First Name: ✻

Cell Phone number:

Please use format 000-000-0000 ✻

Email address: ✻

4-H Club: ✻

Gender:

✻

Male Female Non-Binary

Were you at least 25 years old on December 31, 2025?

Overnight chaperones in Alameda County are required to be 25 years or older. ✻

Yes No

What dates are you available to chaperone? ✻

May 29-May 31, 2026 May 29-June 1, 2026

What is your T-shirt size? ✻

Adult Small Adult Medium Adult Large Adult Extra Large 2X 3X

Is there additional information that you would like the camp kitchen to know about?

Do you have any physical or medical needs you would like to share with the camp heath officer? ✻

Please describe any other overnight chaperone or youth leadership experiences you have had for 4-H or other youth programs/organizations.

For example: Leadership Overnight Chaperone, State Leadership Overnight Chaperone ✻

What if any are your current adult leadership roles in the 4-H program? (e.g. project leader, club leader, event coordinator, etc.). If applicable, list leadership roles in other organizations. Please list all roles you currently hold. ✻

Do you have a current CPR/First aid certification? (This may be attained once you are appointed to the position) ✻

Yes No

Have you ever taken the 4-H Food Safety First course? ✻

Yes No

Have you ever attended any of the following 4-H Camp leadership training opportunities? ✻

Weekend 4-H Camping Conference One Day Camping Institute in Davis Mental Health First Aid Zoom or at Davis

Describe your experience in teaching and working in partnership with youth ages 9-18. ✻

What strategies will you use to create a welcoming camp for diverse youth and adult volunteers? ✻

ANR NONDISCRIMINATION AND AFFIRMATIVE ACTION POLICY STATEMENT FOR UNIVERSITY OF CALIFORNIA

It is the policy of the University of California (UC) and the UC Division of Agriculture & Natural Resources not to engage in discrimination against or harassment of any person in any of its programs or activities (Complete nondiscrimination policy statement can be found at http://ucanr.edu/sites/anrstaff/files/215244.pdf)Inquiries regarding ANR’s nondiscrimination policies may be directed to UCANR, Affirmative Action Compliance & Title IX Officer, University of California, Agriculture and Natural Resources, 2801 Second Street, Davis, CA 95618, (530) 750-1343.

The 4-H Camp fee includes all lodging, meals, activities and a camp T-shirt.

To pay online by Credit Card:

Enter the appropriate amount of the registration payment (DO NOT ADD A $ Sign.)

Chaperones = 100.00

NOTE: Enter the amount without a dollar sign -- If you are having trouble with credit card processing, please view this Credit Card Processing Help Guide.

To pay online by Credit Card: Enter the appropriate amount of the registration payment in the space here:

NOTE: Enter the amount without a dollar sign -- If you are having trouble with credit card processing, please view this Credit Card Processing Help Guide.

✻

required charge

Survey Verification✻

For verification that you are human, please enter the following code in the box below:
PSTYPK

(if the code is not entered correctly, the survey will not be submitted)