Save the date for Camp Rehab: May 27th-29th, 7:30 AM - 3:30 PM!

Camp Rehab is a summer day camp for children with special needs. We need volunteers full of energy who are prepared to help their camper have fun and participate fully to the best of their special abilities in all activities of camp. You will be expected to take part in all of the activities as well. You will be getting hot and dirty! However, you will receive one of the most rewarding experiences of your life!

Accepted applicants will receive an email from camprehab@wtrc.com at a later date with more information.

Buddy / Volunteer Information

Buddy / Volunteer Name

First

Last

Buddy / Volunteer Age

Gender

Male
Female

Address

Address Line 1

Address Line 2

City

State

Zip Code

Email

Have you volunteered in the past?

Affiliated Group or Organization (If any)

Are you capable of acting for a camper?

Can you lift, push a wheelchair, walk long distances, comfortable assisting camper in the pool?

Are you available all 3 days of camp?

May 27th - 29th from 7:30 a.m. to 3:30 p.m.

Shirt Size

Allergies

Emergency Contact

Emergency Contact Name

First

Last

Relationship

Email

Phone

respective broadcasting, Producers

Consent Forms

Informed Consent and Acknowledgement I hereby give my approval for my child’s participation in any and all activities prepared by West Texas Rehab Center during the selected camp. In exchange for the acceptance of said child’s candidacy by West Texas Rehab Center . I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless West Texas Rehab Center and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected camp sessions. In case of injury to said child, I hereby waive all claims against West Texas Rehab Center . including all affiliates, all participants and, if applicable, owners and lessors of premises used to conduct the event.

If the answer is no, your application will not be accepted.

I hereby grant to West Texas Rehabilitation Center, their agents, successors, assignees, and affiliates, and their respective employees, officers, directors, board members, and representatives (collectively “Producers”) the right and permission to film, photograph, and record me, transcribe the recording, and to use my name, voice, image, information about me and any ideas or materials that I provide Producers (collectively, the “Materials”) in works created by Producers (the “Program”) and in connection with advertising, publicizing, broadcasting, producing, and exploiting the Program, in any and all media and mediums now known hereafter developed, in perpetuity. I understand that Producers are under no obligation to incorporate my appearance in the Program. Producer may edit and Video as it sees fit, and may resnlate the Material into languages other than English.

Signature

Clear Signature

If not 18+ a parent or guardian must sign.

Abilene Camp Rehab Buddy Registration

Buddy / Volunteer Information

Emergency Contact

Consent Forms