Thank you for your interest in becoming a Roundhouse Aquarium Summer Junior Camp Counselor! Our summer camp program is very competitive so be detailed in your answers. Complete the form and click the submit button at the bottom of the page.

Personal Information

First name:

Last name:

Title:

Street 1:

Street 2:

Street 3:

City:

State:

* Zip: *

Home phone:

* OK to call me here

Work phone:

OK to call me here

Cell phone:

Email address:

Date of birth:

Age:

Gender:

Adult T-Shirt Size:

Please tell us about yourself in 1-2 paragraphs:

Education

Indicate your education level:

Education:

High School Graduation Year:

High School Name:

College Name (If Applies):

Availability

Indicate the days and times you are available to volunteer.

You must be able to work at least 3 weeks. Monday through Friday 8AM - 1PM in order to become a Junior Camp Counselor. Dates run from July 6th to August 14th. If you are interested in more than 3 weeks, please specify how many weeks in the box below.

Dates include:

Week 1: July 6-10

Week 2: July 13-17

Week 3: July 20-24

Week 4: July 27-31

Week 5: Aug 3-7

Week 6: Aug 10-14

Please write down at least 3 weeks you are available to volunteer (Not every week is guaranteed, so be sure to give your FULL availability)

Volunteer Inquiry

Write 2-3 paragraphs letting us know the following. Answer all questions in your response.

1. Why do you want to volunteer as a Junior Camp Counselor?

2. What you can offer the Roundhouse by volunteering?

3. What do you expect to learn and gain from volunteering.

Skills and Experience

List any special skills (certifications, hobbies, interests, etc.) you possess that would qualify you for our summer camp volunteer position:

Emergency Contact

In the event of an emergency whom should we notify?

First name:

Last name:

Home phone:

Work phone:

Cell phone:

Email address:

Relationship:

Medical Information

Please list any allergies, medication or health concerns:

Convictions

Have you ever been convicted of a crime? If yes, please explain: (Note: Because minors are involved in our programs and are present in the facility, great care must be taken to ensure safety at all times.)

Liability

I am aware of the work related dangers at the Roundhouse Aquarium. I will always use ladders properly, pay special attention to electrical instruments, machines and lights especially when or near water, and be aware of injuries that can occur with certain marine animals. I will never handle an animal without the consent of one of the Roundhouse Staff members. I will not intentionally harm any of the animals and will always use caution when handling or transporting animals.

(please check the box if you comply)

Liability:

Promotional Material

I hereby allow the Roundhouse Aquarium to use my photograph in any promotional material used for the benefit of the aquarium. The Roundhouse will not use these for any other purposes. (please check the box if you comply)

Promotional Materials:

Release of Claims

I hereby waive, give up, and release OTS and the Roundhouse Aquarium (including directors, coordinators, staff members and other agents)and the City of Manhattan Beach from any and all claims arising from any injuries, accidents, illnesses, or other mishaps occurring to me during my volunteer activities as an OTS Roundhouse volunteer. My intention is to release and hold harmless the OTS parties, LACOE, and the City of Manhattan Beach from any claim which I may have in the future regardless of its cause arising from activities which I decide to undertake as an OTS Roundhouse Volunteer.

(please check the box if you comply)

Release of Claims:

Volunteer Agreement

By checking this box, I understand and agree that submitting this application form does not automatically register me as a Roundhouse Aquarium volunteer, and that there may be certain qualifications I must meet, including the acceptance of established volunteer policies and procedures, before I may begin volunteering.

By submitting this form, I attest that the information I have provided on the form is true and accurate and that I must attend a mandatory volunteer orientation and training before starting my volunteer shifts (date TBA).

I Agree