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Kesem 25th Logo


Kesem Volunteer Application 2025

Thank you for your interest in Kesem. We're so excited you're here!

This application covers many of our volunteer positions with Kesem. Please read about the position descriptions here. 

If you'd like to review the narrative questions that will be asked later in the application, click here. 
Applicant Information



If you haven't selected one yet, put "Undecided".

This may be what you consider your "home chapter".

MM/DD/YYYY













Find the position descriptions here.
Kesem Involvement



Please select all that apply

If you are applying to be a counselor this summer, please select "Yes" unless you are a current Kesem alumni who is applying to return as a counselor post-graduation.







Health and Wellness Team Session Selection
You can apply for up to 5 sessions here. Please only choose the sessions for which you are available and willing to attend.

If you are available and willing to attend multiple sessions, but do not have certain sessions in mind, please indicate that below and a member of our team will reach out to you with potential placements. Travel reimbursements may be available.

To view all sessions, locations, and dates, please visit this site for more information.



Session 1 Selection

Session 2 Selection

Session 3 Selection

Session 4 Selection

Session 5 Selection

Session Selection

This will be the session that you are applying to for your Counselor/ Photographer/ Videographer application. If you have selected other application types, those are not affected by this question.
Day Program Session Selection

Narrative Questions





Narrative Questions







Qualifications



Please write your level of fluency for each language you can speak on a scale labeled as either Beginner, Intermediate, Professional, or Native Speaker



Kesem Connections








Volunteer Requirements
Please check each box to indicate that you are aware of the following requirements, if you are selected to be a counselor.
Camp Advisor/Hotline Operator





Registration Review Volunteer





Club Kesem Registration


Select all that apply

Select all that apply





Health + Wellness Team Certifications











Applicant Employment History
Yes No








Camp Volunteer Position Details



i.e. Arts & Crafts, Dance/Drama, Adventure, Nature, Sports, Cooking

Teen Leadership Program (age 17-18) Counselors must be at least 21 years old as of the first day of camp. NOTE: We cannot guarantee you will be put with your preferred age group.

Assistance Needed



Health History Questions
The responses below will not impact the selection process for camp. Health insurance and ability to drive do not impact application standing and are not required to participate. 
Yes No

Dietary Restrictions


Allergy Details

Select all that apply.



Chronic Illness



Immunizations
Because our camp program has a potential for communicable diseases, we recommend that program participants are appropriately immunized for, at minimum, the following diseases: tetanus, mumps, measles, rubella, polio, pertussis (whooping cough), and diphtheria. This being said, we recognize that some individuals may not be fully immunized for reasons that are biophysical (e.g., the individual is allergic to a serum component) or of personal choice (e.g., faith or belief).



I understand that there may be other attendees who have also received no such immunizations, and I assume any associated risk. I agree to waive any cause of action on my behalf that may arise from my contraction of any disease for which I am not immunized, and further I agree to save and hold harmless Kesem, its Directors, Owners, Agents, or Employees, from any claim or cause of action made against it by any third party as a result of my lack of immunizations, including but not limited to any judgement, claim, award, settlement, damages, and/or payments, including attorney's fees and other costs of litigation, and that I am so agreeing in order to induce Kesem to enroll me for the upcoming program season. I understand that in the event of an outbreak of a disease that I am not immunized for, at Kesem's discretion I may be dismissed from programming for all or part of the remaining season, and that in such case no refund or compensation will be given.

Primary Care Physician Contact





Health History Confirmation
This health history is correct and accurately reflects the health status of the individual to whom it pertains. The individual described is able to participate in all activities except as noted by me and/or an examining physician. I give permission to the physician selected by Kesem to order x-rays, routine tests, and treatment related to my health for both routine health care and in emergency situations. I give my permission to the physician to hospitalize, secure proper treatment for, and order injection, anesthesia, or surgery for me. I understand the information on this form will be shared on a “need to know” basis with Kesem Staff. I give permission to photocopy this form. In addition, Kesem has permission to obtain a copy of my health record from providers who treat me and these providers may talk with the program’s staff about my health status.

The responses below will not impact the selection process for camp. Health insurance and ability to drive do not impact application standing and are not required to participate. 
Health Insurance Information






Driving Information
Yes No





Please include contact information for two emergency contacts below who can be reached in the event of an emergency and are authorized and available to pick you up if the need arises.
Emergency Contact #1






Emergency Contact #2






Please provide the contact information for three references who can speak to your experience.
Reference #1





Reference #2





Reference #3





Demographic Questions
Kesem collects demographic information to better meet the needs of the communities we serve by identifying and addressing any gaps in our outreach and support. This information also can be used to gain critical funding to support our programs. These questions are completely optional. 

All responses remain confidential.











Opt-In to Communications

By checking this box you give permission to Camp Kesem to send you text messages to the mobile phone number(s) provided. Your information will not be shared with third parties. Message and data rates may apply.


By checking this box you give permission to Camp Kesem to send you emails to the email address(es) provided. Your information will not be shared with third parties.

Waivers and Agreements
Please read the following waivers and agreements carefully. They include release of liability and waiver of legal rights, and deprive you of the ability to sue certain parties. By agreeing electronically, you acknowledge that you have both read and understood all text presented to you as part of the registration process.
By entering my name below, I assert that I have reviewed and agree to all the waivers and agreements I selected above:

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