Lincoln, NE Area Camp 2021 

Carol Joy Holling Conference & Retreat Center | Ashland, NE

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Location Information

  • Carol Joy Holling Conference & Retreat Center
  • 27416 Ranch Rd., Ashland, NE, 68003 US

You  are completing this form to be a volunteer of Retreat & Refresh Stroke Camp. Please complete all requested information in each section. Volunteers are required to be at least 18 years of age and be in good health. Anyone younger than 18 will need to request a youth volunteer application for consideration. It is your responsibility to let us know if special accommodations need to be arranged. Healthcare background or training is welcomed, but not necessary.

All volunteers are asked to arrive at camp by 9:30 AM on Friday and asked to stay for the duration of the weekend! Camp ends Sunday afternoon around 2:00 PM. Preference will be given to volunteers who are able to stay for the entire weekend.

COVID-19 QUESTIONS

In consideration of the health and safety for all of our participants:


BASIC INFORMATION

Age should be between 18 and 89 as of August 27th, 2021


EMERGENCY CONTACT INFORMATION


ADDITIONAL HELPFUL INFORMATION

Our best efforts will be made to accommodate your request, however if you are concerned about having food available that you can eat, we suggest bringing snacks and/or food to supplement your diet.


STROKE CAMP VOLUNTEER EXPECTATIONS

ARRIVAL

Your commitment for the retreat weekend would begin by 9:30 am Friday morning for a team building activity and end Sunday around 2:00 PM. For the comfort of our survivors and the continuity of the weekend, it is IMPORTANT to make every effort to attend the entire retreat!

Stroke Survivors and caregivers arrive between 1:30 PM and 3:30 PM on Friday and depart at the close of the event Sunday. We ask that volunteers plan to attend the entire weekend retreat unless other arrangements have been made.

CAMP DATES: Friday, August 27-Sunday, August 29, 2021

ACTIVITIES

Volunteers are NOT expected to assist survivors and caregivers with activities of daily living (bathing, dressing, grooming, etc...) The following activities are some you MAY be asked to assist with while at camp. Volunteer assignments are made AT camp, and all volunteers are asked to assist where ever they see a need. (Activities vary based on retreat center, location, time of year, and accommodations.)

  • Crafts
  • Massage
  • Rock Climbing
  • Discussion Groups
  • Sports
  • Manicures
  • Education Sessions
  • Paraffin Dip
  • Fishing
  • Assisting survivors through buffet line
  • Snack preparation
  • Decorating for theme
  • Swimming
  • Boating
  • Registration/Admin.


ROOM ASSIGNMENTS

Depending on the facility, volunteers typically share a sleeping room with one or more volunteers of the same gender. If you have a friend, colleague, or spouse volunteering for this camp that you would like to room with, please list their name(s) here. While there are NO guarantees, we will do our best to accommodate rooms requests.


INTERESTS AND CONFIRMATION

There are opportunities for educational/experiential sessions throughout the retreat weekend. If you have a topic of interest and would like to present, please list it here and we will be in touch.

Approximately one or two weeks before camp, VIA EMAIL, you will receive:

  • Weekend Schedule
  • Directions to Camp
  • Packing Check Guide
  • Address List
  • List of Roles and Expectations

AGREEMENT

AUTHORIZATION FOR USE AND/OR DISCLOSURE OF INFORMATION AND GENERAL RELEASE

I hereby authorize Retreat & Refresh Stroke Camp ("Camp") to use, publish, and/or disclose my Individual Identifiable Information ("Information") as described herein. This authorization is voluntary. No individual has coerced or forced me into signing this authorization. I am providing this authorization under my own free will. I am under no legal liability.

I understand that Camp may benefit, monetarily, non-monetarily, or otherwise, from the use of my own Information. I understand that I will not be entitled to any of said benefits and specifically release all claims to same. I understand that once Information is received by Camp, then it may be subject to re-disclosure and may no longer be protected by federal, state, or local laws. I waive any claims of violations of federal, state, or local laws which are the result of re-disclosure.

A. Individually Identifiable Information includes, but is not limited to:

  • Video or photos of me
  • Interviews of and statements by or about me (including the use of audio or video recording devise); and
  • Mentions of my medical situation and specific health information.

B. Purpose of request:

  • For publication in print, digital, or electronic media and in any forum; and
  • For inclusion on the Camp website or other promotional material.

C. Right to Revoke

I acknowledge that I have the right to revoke this authorization only in writing. Any revocation will be prospective and not retrospective.


By checking the box below, I acknowledge and affirm the statements in this authorization form.


STROKE CAMP VOLUNTEER POLICIES AND PROCEDURES

Each member of the Retreat & Refresh Stroke Camp (hereafter "camp") staff: counselors, activity staff, medical staff, and administrative staff has a RESPONSIBILITY to provide for and protect the health and well-being of campers (stroke survivors and their caregivers).

Please read the following Practices and Policies Agreement CAREFULLY AND THOUGHTFULLY then sign the statement of the compliance that follows.


MEDICAL SERVICES: The camp nurse must be advised promptly of any injuries or health problems. All volunteers must follow decisions made by camp nurse for themselves and campers.

TELEPHONE CALLS: Volunteers will not be paged for calls, except in case of emergency. The facility phone cannot be used for personal calls. Cell phones can be used during free time, but are to be kept silent during camp group activities. Cell coverage is spotty at many of our camp locations.

VALUABLES AND CASH: Everyone is urged not to bring highly valued clothing and accessories. The Camp cannot be responsible for loss or damage to person property.

PROFESSIONALISM: Confidential information given and received before, during, or after camp must be held in confidence. Volunteers must act professionally toward all campers.

SMOKING: Smoking on the camp grounds is forbidden and is extremely dangerous to the environment, and the health of you and those around you. If smoking is permitted, there will be a designated area to be used during your breaks.

ALCOHOL AND DRUGS: The use of alcoholic beverages or illegal drugs while caring for stroke survivors and their caregivers is strictly forbidden and will be considered grounds for selling a volunteer home. To be under the influence of alcohol or drugs in camp is not consistent with a volunteer's responsibility to the campers. Camp Nurse or the Camp Director can release anyone who is under the influence during the weekend.

CAMP SITE REQUIREMENTS: All volunteers and campers must abide by the contractual agreement signed by Retreat & Refresh Stroke Camp.

SAFETY AT CAMP: In order to protect both campers and volunteers, strict safety policies will be followed which include the Golf Cart and Walkie Talkie policies listed below:

GOLF CARTS: Golf carts are for the purpose of transporting stroke survivors and caregivers between points at camp or moving equipment when necessary as well as for golf cart tours for the survivors and caregivers. The Camp Director will appoint golf cart drivers for the camp. Any use other than what is listed above must be approved by the camp director. ANYONE UNDER THE AGE OF 18 OR WHO DOESN'T HAVE A VALID DRIVERS LICENSE IS PROHIBITED FROM DRIVING GOLF CARTS.

WALKIE TALKIE USE: Often camp locations have poor or spotty cell phone coverage. Because of that fact, if there is an opportunity for campers to explore the outdoors and be away from the camp site, they must be accompanied by volutneers who have a walkie talkie. The base will be left with someone at the main site and agreed upon through the Camp Director before departure.


I acknowledge that I am volunteering to perform services for Camp, with no expectation of pay or remueration of any kind. I understand that I will not be employed by or be an employee of Camp. Because I will not be an employee, I understand that I will not be covered by either state unemployment or state workers' compensation laws or any camp insurance policy.

I further acknowledge that my volunteer services will not entitle me to any employee benefits provided by Camp to its employees. Either I or Camp decided to terminate my volunteer services at any time and for any reason, or without notice.

I have read the above Practices and Polices and agree to abide by the regulations established or the retreat. I am fully aware that adhearing to the rules will be my sole responsibility. Deviation from these rules my be cause for immediate dismissal from Camp.

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