Full Name

Mailing Address

City State

Zip Code

Email Address

Day Phone Number

Cell Phone Number

Select your volunteer category.

Counselor in Training (ages 13 - 17)
Volunteer (age 18+)

List the dates and times you are available to volunteer. Volunteers are needed June 20-23;
8:30 a.m.- 4:30 p.m.

Select the area you are interested in volunteering for.

Clinical Assistance
Snack Preparations
Camp Counselor
Crafts
Recreation

Select your T-shirt size.

Select a Size Small Medium Large X-Large 2x-Large 3x-Large

Are you a Floyd employee? Yes No

If yes, please provide your department name?

Is this your first time to volunteer for Kiki's Kids Camp?
Yes No

If yes, how did you hear about Kiki's Kids Camp?

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