Camp HEAL Volunteer Application

Camp H.E.A.L
(Healing and Encouragement After Loss)

Sponsored by Hospice of Southwest Georgia
114-A Mimosa Drive, Thomasville, GA 31792

Volunteer Application
*Application Deadline is September 29, 2017 or until enrollment number is reached

Volunteer space is limited.

Event Date: October 21, 2017
Camp Piney Woods, Thomasville

Archbold Medical Center of Affiliate Employee/Volunteer

*Requires professional certification

Please complete the following to help us prepare the most enjoyable and comfortable volunteer experience for you.

Please provide three references and their relationship to you.

Information Release

  1. I understand that participation in Camp H.E.A.L. is voluntary.
  2. I understand taht participation in Camp H.E.A.L. is contingent on my background check.
  3. I give permission for Camp H.E.A.L. to process the necessary paperwork through Archbold Medical Center’s human resource department to conduct a criminal background check.
  4. I understand that I will be required to provide a copy of my professional license prior to camp if I agree to participate in an activity requiring a license.
  5. I understand that I will be required to participate in a Camp H.E.A.L. volunteer training program prior to camp.  Camp training is strictly enforced for all new and returning volunteers.  NO EXCEPTIONS.
  6. As a volunteer of Camp H.E.A.L., I release John D. Archbold Memorial Hospital, Inc., Archbold Health Services, Hospice of Southwest Georgia, Camp Piney Woods and The Painted Pony from liability for any injuries or damages sustained in an activity sponsored by Camp H.E.A.L.