City of Melbourne, Parks & Recreation Department Volunteer Jr. Counselor General Information The Volunteer Jr. Counselor program is where the students have the opportunity to assist with the dayto-day operations of Summer Camp while also learning important life skills. They assist a group by acting as a junior counselor doing tasks like helping kids line up, setting up, and taking down games, teaching young campers games and so on. They are generally placed in the youngest groups where they have the best opportunity to experience what the counselors do each day. Through all of this, they earn respect from the campers and counselors and hopefully learn some valuable skills along the way. Your application packet should contain: An information letter to parents/students regarding the Volunteer Jr. Counselor program A Volunteer Jr. Counselor Application A 2-page packet to be turned into the teacher of their choice (letter of recommendation) A general camp registration packet (registration form, medical form, rules and regulations) Volunteer Jr. Counselor positions are filled by the best qualified volunteers on a first come first served basis as space is limited. Applications can be turned in at Lipscomb or at the Wickham Park Community Center. After the packet is returned, parent/student will pick an interview time on the days set by your facility/camp location. Parents/Students will be notified within a week following the interviews whether or not their child was selected and for which weeks. Within a week of the selection, parents are expected to pay the camp registration fees in full. Volunteer Jr. Counselors are responsible for paying 50% of camp fees. Volunteer Jr. Counselors may only participate for up to 5 weeks of camp (space permitting) All Volunteer Jr. Counselors must attend the mandatory training- Date and time TBA Service as a Volunteer Jr. Counselor may qualify as service credit. If the child will be requesting credit for serving as a Volunteer Jr. Counselor through the Bright Futures program or another service program, please submit paperwork to the camp director. Please keep in mind that Bright Futures service credits requires approval of the credits from the student s high school prior to volunteering. Many applicants to the volunteer Jr. Counselor position want to attend Teen Extreme Camp as well as volunteer as a Jr. Counselor. If this applies to your child, it is strongly recommended that you register and pay for the weeks that you are most interested in Teen Extreme Camp as space in the Teen Extreme Camp Program is limited. If your child is accepted as a Volunteer Jr. Counselor, camp fees will be adjusted accordingly. Volunteer Jr. Counselors are held to the same discipline policy as the campers are; it is expected that the Volunteer Jr. Counselors be mature and responsible and follow directions. The Volunteer Jr. Counselors that do not follow our policies and rules; the discipline process will be followed, which may lead to suspension or removal from camp.
To Students and Parents: The City of Melbourne, Parks and Recreation offers teens ages 13-15yrs the opportunity to volunteer as Jr. Counselors in our Lipscomb or Wickham Park Summer Camp programs. The teen volunteers involved in this program will also learn great life skills through mentoring, career shadowing, and participation in recreation programming. The following are the basic requirements for the program; Must have completed 6 th Grade Must complete the application Must have teacher or other mentor complete recommendation letter & form Must be interviewed by a City of Melbourne Parks & Recreation Supervisor Must attend the mandatory orientation meeting at set date & time Must have parent complete the Summer Camp registration and medical information forms Volunteer Jr. Counselors are responsible for paying 50% of camp fees. If you have any questions or concerns, please feel free to contact your Recreation Supervisor: Wickham Park Community Center: Chris Mavis, Sr. Recreation Supervisor (321)608-7490 Lipscomb Community Center: Art Brown, Sr. Recreation Supervisor (321)608-7450 Volunteer Jr. Counselor positions are filled on a first come, first served basis as space is limited. Applications can be turned in at Lipscomb or at Wickham Park Center during normal business hours.
PERSONAL INFORMATION Name Years known Name Years known Name Years known SHORT QUESTIONS: Why do you want to volunteer in the Asst. Counselor Program? What do you hope to learn from the volunteer program? Volunteer Assistant Counselor Application Last Name First M.I. Date Street Address Apt/Unit # City State Zip Email Address Birthdate: Phone Emergency Contact Have you ever attended Camp before? YES NO If yes, where? Have you ever been a Jr. Counselor before? YES NO If yes, where? AVAILABILITY (circle location): LIPSCOMB WICKHAM PARK What weeks are you available this Summer? (circle weeks) 1 2 3 4 5 6 7 8 9 Will you be attending Teen Camp as well? Would you be interested in volunteering with Parks & Recreation throughout the year? (Special events, etc) If yes, please list area of interest and availability (once a month, once a week, etc) REFERENCES Please list 3 non-family members (who have known you for at least one year), that can provide references on your ability to perform as a Volunteer Asst. Counselor (such as teachers, coaches, families you have babysat, etc) Address Address Address How acquainted? Phone ( ) How acquainted? Phone ( ) How acquainted? Phone ( ) I agree to abide by and comply with all rules, regulations, policies, and practices of City of Melbourne Parks & Recreation and with all procedures established for volunteers. I have read and understood the rules. I agree to conduct myself in a courteous and professional manner while volunteering as a Jr. Counselor. Furthermore, I understand that failure to do so will result in suspension/dismissal from junior counselor program. I understand that the Jr. Counselor position is a volunteer position, is not a paid position, and that I will not be guaranteed a position with the City of Melbourne in the future. Participant Signature: Date:
Parental/Guardian Permission Form for Volunteer Asst. Counselor Program Child Last Name Child First M.I. Date Parent/Guardian Last Name Parent/Guardian First Name: Read this section carefully before you sign the authorization below (required for volunteers under age 18) I, as the parent and legal guardian of my child (insert name of child), request the City of Melbourne to consider my child for a Volunteer Asst. Counselor position in City of Melbourne Parks & Recreation Program. Transportation: My child will be: dropped off by parent walking/riding bike Other (specify) LAW VIOLATION RECORD 1. Has your child ever been found delinquent, convicted, pled no contest or nolo contendere, or had the adjudication of guilt withheld in connection with any criminal offense? YES (If yes, please see Camp Supervisor) No 2. Has your child ever been expelled or suspended from school attendance at any private or public school for a violation of school board policy or rule relating to weapons, alcohol, or drugs, or the willful infliction of injury to another person? YES (If yes, please see Camp Supervisor) No 3. Has your child ever violated state or federal law relating to weapons, alcohol, or drugs or the willful infliction of injury to another person? YES (If yes, please see Camp Supervisor) No Note: a 'yes' answer to this question will not automatically bar your child from volunteering. The nature, job-relatedness, severity, and date of the offense in relation to the volunteer assignment will be considered. As parent and legal guardian of the above-named child, I agree to the terms of my child's Application for Volunteer Jr. Counselor, this Permission Form and the Volunteer Asst. Counselor program and agree that all terms binding on behalf of the child shall also be read as binding on me personally. I certify that all information in my child's Application for Volunteer Asst. Counselor and this Permission Form and all other information provided by me and my child in support of my child's Application for Volunteer Jr. Counselor and this Permission Form are true and correct to the best of our knowledge. We understand and agree that any misrepresentation of information, whether provided or by having failed to provide, shall be considered a valid basis for rejection of this volunteer application and/or discharge from the Asst. Counselor Program. I authorize City of Melbourne Parks and Recreation to verify information listed in this application and to contact the listed references. I understand that background screening will be conducted as it applies to the volunteer assignment in which my child has expressed an interest and I give my consent to the same. I understand that the City of Melbourne is a governmental entity subject to the public records law and that certain records regarding my child may be considered by law to be a public record subject to disclosure upon request. If my child is selected as a Jr. Counselor, I understand that my child will be a volunteer and will not be an employee of the City of Melbourne and will not be entitled to salary or other employee benefits. I am the parent/legal guardian of the above-named child. I hereby grant permission for my child to participate in the various trips/programs sponsored by the City of Melbourne, Parks & Recreation Department as a Volunteer Asst. Counselor. I understand that my child's participation in camp programs (on City property as well as on field trips) entails certain risk and hazards. In consideration of my child being permitted to participate in the Jr. Counselor program, on behalf of myself, my child, and my/our heirs, assigns, personal representatives and next of kin, I agree to release, waive, discharge and covenant not to sue and agree to indemnify the City of Melbourne, its agents, representatives, employees and assigns for all claims, damages, injuries, losses or other liabilities, attorneys fees and costs, or causes or action which are in any way connected with my child's particpation in the Jr. Counselor program or use of equipment or facilities of the program, arising out of or resulting from my child's participation in the program to the fullest extent permitted by law. Nothing herein is intended to alter, extend or waive any defense or sovereign immunity under Section 768.28, Florida Statutes or otherwise provided Parent/Guardian Signature: Date:
Dear Mr/Ms (teacher/mentor): The following student is applying to be a Volunteer Jr. Counselor with City of Melbourne Parks & Recreation. This program allows teens to earn community service hours by volunteering at our camp programs. In order to obtain students who will be successful in this program, we are requesting your help. Please write a recommendation letter detailing this student s qualifications and achievements. This letter should be written on your school or organization s letterhead. Also, please complete and sign the attached recommendation form. When completed, please put the recommendation letter and form in an envelope and sign across the flap of the sealed envelope. The envelope can then be returned to the student to turn into the Camp Supervisor. Thank you for your assistance. Sincerely, Kristin Swenson City of Melbourne, Parks & Recreation Recreation Manager (321)608-7400
Teacher/Mentor Evaluation for Volunteer Junior Counselor STUDENT INFORMATION Name: School: RATINGS Student Behavior Work Quality Attendance/Punctuality Initiative Communication/Listening Skills Dependability/Responsibility Grade: 1 = Poor 2 = Fair 3 = Satisfactory 4 = Good 5 = Excellent OVERALL RATING: # BLOCKS MARKED @ 5: X 5 POINTS = POINTS # BLOCKS MARKED @ 4: X 4 POINTS = POINTS # BLOCKS MARKED @ 3: X 3 POINTS = POINTS # BLOCKS MARKED @ 2: X 2 POINTS = POINTS # BLOCKS MARKED @ 1: X 1 POINTS = POINTS TOTAL BLOCKS: 6 TOTAL POINTS Total Points Divided by Total Blocks(6) = Overall Score EVALUATION Please Provide Additional comments about the student Teacher Printed Name: Teacher Signature: Email: School: Date: Phone #: