Volunteer Application | Wendt Center for Loss & Healing

Application Instructions

If you have any questions, please email volunteer@wendtcenter.org.
The form must be completed in one session, and required fields are indicated.
If you are missing fields, they will show in red and you cannot go to the next page without completing.
At the bottom of each page of the application, click “Next”. When you reach the end, click “Submit”. You will receive an email confirmation once you submit your completed application.
Once you finish reading these instructions, you may collapse this box by clicking the minus in the top right corner.

Camp Volunteer Application

Comments

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CampYear

Thank you for your interest in volunteering at the Wendt Center’s Camp Forget-Me-Not/Camp Erin DC. All potential volunteers must complete this application.

Personal Information

Your name(Required)

First Middle Last

What name would you like to be called at camp?

Have you volunteered at Camp Forget-Me-Not/Camp Erin DC before?(Required)

Yes

In which year(s) were you a volunteer?(Required)

2025

2024

2023

2022

2021

2019

2018

Before 2018

Your Date of Birth(Required)

Your age

Your email(Required)

Enter Email Confirm Email

Your phone number(Required)

Your Address(Required)

Street Address Apartment # City State/Jurisdiction ZIP / Postal Code

How do you identify?(Required)

If other, please describe(Required)

What are your pronouns?(Required)

If other, please describe:(Required)

Your race/ethnicity(Required)

Check all that apply.

African American or Black

American Indian//Indigenous/Alaska Native

Asian

Hispanic/Latino/a

Middle Eastern or North African

Native Hawaiian or Pacific Islander

White

Another Race not Listed

I prefer not to answer

What size T-shirt do you prefer?(Required)

Adult-Small

Adult-Medium

Adult-Large

Adult-X-Large

Adult-XX-Large

Adult-XXX-Large

Can you wear last year (2025)'s T-shirt?

Yes

I’m not sure

Do you have any dietary considerations?(Required)

None

Vegetarian

Vegan

Gluten-free

Dairy-free

Food allergy (you’ll be asked to elaborate later)

Other

If other, please describe:(Required)

Have you ever served in the US Military?(Required)

Yes

If so, which branch(es)?(Required)

Air Force

Army

Coast Guard

Marines

Navy

Space Force

What is your current military status?(Required)

Active

Reserve

Veteran

Have you ever received therapy services at the Wendt Center?(Required)

Yes

Did any of your therapy services take place after January 1, 2026?(Required)

Yes

Unfortunately, we cannot accept volunteers at camp who participated in our therapy services after January 1st. We are so grateful for your interest and sincerely hope that you’ll apply again in the future!

How did you learn about Camp Forget-Me-Not/Camp Erin DC?(Required)

Check all that apply

Training, presentation, or outreach event by the Wendt Center

Wendt Center staff

Wendt Center volunteer

Friend/Colleague

Wendt Center Website

Search Engine

Social Media

Listserv/Community posting

Other

Who referred you?(Required)

We would love to thank them for the connection.

If other, please describe:

Who is your current employer?

Volunteering Preferences

At which camp(s) are you interested in volunteering?(Required)

Check all that apply.

6-9 year olds: Saturday, June 27, 2026

10-12 year olds: Saturday, July 11, 2026

13-17 year olds: Saturday, July 25, 2026

What volunteer role(s) are you interested in?(Required)

Check all that apply.

Camper support

Grief group facilitator (must be licensed MHP)

Medical team

Fresh Legs (dinner and cleanup crew)

Set up (the Friday before camp)

Bereavement History

To help us match the grief histories of volunteers and campers, we ask you to share information about the death(s) of a person(s) close to you.

Person's Relationship to you(Required)

If other, please describe:(Required)

Person's Cause of Death(Required)

If other, please specify:(Required)

How old were you when the person died?(Required)

When did the death occur?(Required)

Would you like to add another person?(Required)

Yes

Person's Relationship to you(Required)

If other, please describe:(Required)

Person's Cause of Death(Required)

If other, please specify:(Required)

How old were you when the person died?(Required)

When did the death occur?(Required)

Would you like to add another person?(Required)

Yes

Person's Relationship to you(Required)

If other, please describe:(Required)

Person's Cause of Death(Required)

If other, please specify:(Required)

How old were you when the person died?(Required)

When did the death occur?(Required)

Health Information

What is your insurance carrier?(Required)

Do you have any of the following health conditions?(Required)

If other, please specify(Required)

Allergies(Required)

Please use the plus sign to add a new line for each allergy.

Allergen

Reaction

Requires EpiPen?

When was your last seizure?(Required)

An approximate date is fine.

Do you use an inhaler?(Required)

Yes

Do you take any regular medications?(Required)

Yes

Medications(Required)

Please use the plus sign to add more medications if needed.

Name

Dose

Frequency

Purpose

Do you have any physical activity restrictions?(Required)

Yes

If yes, please describe.(Required)

Emergency Contact

Please make sure your listed emergency contact is someone who will be available on the date(s) you hope to volunteer on.

Emergency Contact Name(Required)

Emergency Contact Phone Number(Required)

Emergency Contact Relationship(Required)

If other, please specify:(Required)

References

New volunteer applicants are required to obtain two non-family references. One should be a personal reference and the other a professional reference.

The Wendt Center will send an email to these two individuals informing them of your interest in volunteering at Camp and requesting that they submit a confidential reference to us online. We will not be able to process your application until both references are submitted.

You will receive notification when each reference is submitted. Once both references are received, you will be contacted to set up a virtual interview.

First Reference – Name(Required)

First Last

First Reference – Email(Required)

Enter Email Confirm Email

Second Reference – Name(Required)

First Last

Second Reference – Email(Required)

Enter Email Confirm Email

Background Check

For all Camp volunteers we require either:

An active DC healthcare license, or
A background check conducted by the Wendt Center.

Are you currently a Licensed DC healthcare or mental healthcare provider?(Required)

Yes

Please upload a copy or photograph of your license.(Required)

If you did not receive a physical license, please use this website to search for your license and take a screenshot or picture of it: https://dohenterprise.my.site.com/ver/s/

Max. file size: 128 MB.

Volunteer Agreements

The Wendt Center Confidentiality Agreement

As a volunteer, employee, contractor, or vendor of the Wendt Center for Loss and Healing, you have a responsibility to safeguard the privacy and confidentiality of information obtained in your role. You may have access to information that would be considered Protected Health Information (PHI) or Confidential Business Information (CBI).

“Need to Know” is defined as information which is required in order to perform specific job duties or participate in the directed scope of activities at the Wendt Center.

Protected Health Information (PHI) is defined as identifiable health information including but not limited to name, address, contact details, and full-face photographic images, as well as specific details of a person’s past, present, or future condition when there is a reasonable basis to believe the information can be used to identify the individual in question.

Confidential Business Information (CBI) is defined as proprietary information which concerns or relates to processes, operations, styles of work, identification of customers, amounts and sources of income, profits, losses, or expenditures, or any other information of commercial value.

PHI or CBI should only be obtained, used, or communicated when there exists a “Need to Know” the information, and disclosure is permitted only when the involved parties all have a “Need to Know”. Access to and disclosure of PHI in all other circumstances is strictly prohibited by state, district, and federal law.

By signing below I hereby agree that:

I will not OBTAIN, USE, or COMMUNICATE any PHI or other information about individuals or families receiving services from or participating in programs at the Wendt Center unless I have the “Need to Know”.
I will not OBTAIN, USE, or COMMUNICATE any CBI of the Wendt Center unless I have the “Need to Know”.
I will take precautions to avoid accidental disclosure of PHI or CBI, including:

Not discussing such information when or where I am likely to be overheard;
Not writing, recording, or otherwise storing such information unless it is necessary;
In situations when storing information is required, ensuring that it is protected by a password and/or locked where only those with the “Need to Know” have access,
Not disclosing, copying, or being careless with any passwords, codes, or keys given to me in my role;
If accessing electronic or written records, not doing so in a manner in which they are readable by people without the “Need to Know”, and not leaving them unattended without re-securing them by password or lock.

I will immediately report any breach of confidentiality that I witness or commit, whether accidental or purposeful, to the staff member supervising my volunteering, and will provide my report verbally or in written format as directed including, if appropriate, to the management of the Wendt Center and/or the HIPAA Compliance Officer.
Failure to safeguard PHI and CBI results in harm, and such an offense may result in disciplinary action possibly to include termination of my volunteer position and/or contractual or employment relationship with the Wendt Center.

Signature(Required)

Liability Release

In return for being permitted to participate as a volunteer, I release and discharge the Wendt Center for Loss and Healing, Camp Forget-Me-Not/Camp Erin DC, its Board of Directors, Officers, Employees, Volunteers, Successors and Assigns from any and all liability, claims and demands of whatever nature that may be made by me, my family, estate, heirs, or assigns for any injuries I have or may sustain in connection with my participation as a volunteer.

Please indicate your agreement by signing below.

Signature(Required)

Publicity Permission

I understand that in connection with my participation as a volunteer at the Wendt Center for Loss and Healing, Camp Forget-Me-Not/Camp Erin DC, the Wendt Center or its agents may record my image or words by digital, video, audio, photographic or other means and/or transcribe in writing any interview I conduct with or on behalf of the Wendt Center. I consent to the Wendt Center’s use of such recordings, images and/or transcriptions (collectively the Materials) for any and all non-commercial purposes consistent with the tax-exempt purposes of the Wendt Center. I waive the right to inspect and/or approve any such use of the Materials. I understand that the Wendt Center is not obligated to use any or all of the Materials.

I understand and acknowledge that I will receive no payment for the use of the Materials. I also understand that the Wendt Center may authorize representatives of the news media to photograph, record and/or interview volunteers. I consent to being photographed, recorded and/or interviewed by the news media as so authorized.

I release the Wendt Center from any claims that may arise regarding the use of the Materials or authorization to the news media including, but not limited to, any claims of defamation, invasion of privacy, rights of publicity or copyright.

Please indicate your agreement by signing below.

Signature(Required)

“Sponsor A Camper” Fundraiser

All camp volunteers are required to fundraise $350.00 as part of their participation in Camp Forget-Me-Not/Camp Erin DC so that we can offer this camp without charge to children and families.

Please indicate your agreement by signing below.

Signature(Required)

Camp Social Media Policy

Volunteers at the Wendt Center’s Camp Forget-Me-Not/Camp Erin DC are encouraged to post on social media about their experience. To safeguard the confidentiality of and out of respect for the privacy of participants, their families, and the reputation of the Camp Program, I agree to abide by the following restrictions and guidelines: I will not post identifying information about any campers or family members, including details of their stories, and will take care to reference the definition of PHI outlined in the Confidentiality Agreement. No unsanctioned images of campers shall be posted – all campers whose images are published by the Wendt Center have explicit written consent from their legal guardian on file, even in a situation where the camper appears in the background of an image. Only Camp Staff can authorize posting of photos which include campers. I will make sure to associate any posts about my participation with the Wendt Center and Camp Forget-Me-Not/Camp Erin DC including by tagging the official Wendt Center account if one exists on that platform, and by including any language or hashtags that I am directed to by Wendt Staff.

Please indicate your agreement by signing below.

Signature(Required)

Authorization for Emergency Medical Treatment

Should a medical emergency arise during my participation in a Camp Forget-Me-Not/Camp Erin DC activity, and I am unable to speak or provide consent on my own behalf, I hereby consent to receive medical treatment deemed necessary under the circumstances by camp medical staff and/or 911, and assume the liability for any medical expenses involved. This includes providing consent for immediate administration of life-saving measures as well as consent to be transported to a medical facility if appropriate. This authorization extends to my participation in any activity sponsored by Camp Forget-Me-Not/Camp Erin DC.

Please indicate your agreement by signing below.

Signature(Required)