Special Needs Volunteer Form Name* First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSaint MartinSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Phone*Email* Enter Email Confirm Email Age*Gender*MaleFemaleWhat 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 BuddyMaterials VolunteerAre you available Monday through Friday from 7:45-11:15 during the week of Aug 6th - Aug 10th?*YesNoPlease 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?*YesNoDo you have any physical limitations that would prevent you from running or participating in the sport / modeling skills with a child?*YesNoPlease 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?*YesNoHave you served in Kids Therapy sports programs in previous years?YesNoIf 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)?*YesNoplease 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!