Camp HEAL Volunteer Application
Application Deadline is September 30, 2026
Name
First Name
Middle Initial
Last Name
Preferred Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Home Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Cellphone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Work Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
example@example.com
T-Shirt Size
Do you work or volunteer for Archbold Medical Center or any of the affiliate facilities?
Yes
No
Archbold Division
Archbold Department
If you do not work for Archbold, additional forms will be sent via email and must be completed and returned in a timely manner.
Employer
Occupation
Professional License/Credentials
Special Talents or Hobbies
I am interested in volunteering as:
Team Leader* - Lead camper groups
Group Buddy - Assist Team Leader with groups
Activity Assistant
Hospitality (Food service for two meals)
Floater
*Requires professional certification
Why would you like to be a Camp HEAL volunteer?
Have you experienced the loss of a loved one recently?
Yes
No
If yes, when and how did it affect you?
Previous volunteer experience
Please complete the following to help us prepare the most enjoyably and comfortable volunteer experience for you.
Emergency Contact Name
First Name
Last Name
Relationship
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Home Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Cellphone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Do you have any food allergies or dietary restrictions?
Yes
No
If yes, please explain.
Do you have any health restrictions?
Yes
No
If yes, please explain.
Please provide three references and their relationship to you.
Name
First Name
Last Name
Relationship
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Name
First Name
Last Name
Relationship
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Name
First Name
Last Name
Relationship
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Information Release
I understand that participation in Camp HEAL is voluntary. I understand that participation in Camp HEAL is contingent on my background check (if not an Archbold employee).I give permission for Camp HEAL to process the necessary paperwork through Archbold’s Human Resources Department to conduct a criminal background check. 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. I understand that I will be required to participate in a Camp HEAL volunteer training program prior to camp. Camp training is strictly enforced for all new and returning volunteers. NO EXCEPTIONS. As a volunteer of Camp HEAL, I release John D. Archbold Memorial Hospital, Inc., Archbold Health Services, Archbold Hospice, Camp Piney Woods, YMCA and any of their agents from liability for any injuries or damages sustained in an activity sponsored by Camp HEAL.
Signature
Submit
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