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Personal Info

Name*

First Last Preferred Name (for nametag)

Date of birth*

Contact Details

Mobile Home

Email*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Emergency Contact

Name*

First Last Relationship to you

Contact Details

Mobile Home

Email

WWCC details

WWCC

Number Expiry

Camp Preferences

Positions Available*

Cabin Leader
General Helper
First Aider

Descriptions of each position available on Volunteer Page. Cabin Leaders are in highest need in order for camps to go ahead.

Camp dates*

Select All
2025 January Camp #313 Monday 6th - Friday 10th
2025 April Camp #314 Monday 7th - Friday 11th
2025 September Camp #315 Monday 22nd - 26th

Medical Info

Do you have any of the following:*

If you ticked yes to any of the above, please provide more information here

Do you have any allergies?*

Are you anaphylactic?

If you have allergies, please write them in here

GP info*

Doctors Name Clinic Name Contact Number

Medical Info

Ambulance Cover Medicare Number

Private Health

Private Health Fund Number

Date of last tetanus shot*

If you are taking medication during the camp that may impact on your ability to preform your duties, you are required to advise camp staff. You must ensure any personal medication is stored in the first aid room, no medications are to be left in cabins. Please provide a list of any medications you will be bringing to camp

Dietary Requirements*

None
Vegan
Vegetarian
Halal
Gluten Free
Lactose Free
Dairy Free
Other

If you ticked yes to any of the above, please provide more information here

Is there anything we should know about that could potentially impact your full participation on camp?*

About You

Have you ever volunteered at a Licola camp before?*

Do you have any previous experience working with children? If yes, please provide more information here*

Are you attending camp for "student placement?*

If yes, what are you studying?

Institute

Campus Contact Person Contact Number

Why do you want to attend a Lions Sponsored Camp?*

What qualities will you bring to camp?*

Please upload a current photo of yourself*

Max. file size: 2 MB.

Consent*

I agree to the following:

I understand that approval to act as a volunteer is entirely at the discretion of LVL and may be withdrawn should my behavior put at risk any child, leader or property, or for any other reason communicated to me by the Camp Manager. I have read all relevant Lions Village Licola Inc. policies in relation to Lions Sponsored Camps and the ‘Child Protection Policy & Code of Conduct’. I agree to abide by all conditions.

In the case of serious emergency and if I am unable to give necessary consents, I direct LVL Directors and staff to consent to any medical or surgical treatment including anaesthetics, as necessary on my behalf and accept full responsibility for any such expenses incurred.

I also consent to my image being used in public relations efforts for Lions Village Licola Inc. including, but not limited to media releases, brochures and videos.

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Phone

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Volunteer Application

Personal Info

Emergency Contact

WWCC details

Camp Preferences

Medical Info

About You