1 Start 2 Complete Name * Home Address * Email Address * Phone Number * Marital Status Single Married Divorced Widowed T-shirt Size (Many activities will require volunteers to wear t-shirts with church or event logo) What area are you interested in volunteering for? (Example: Kids Sunday mornings, Kids Wednesday night, Nursery, Junior High, Senior High) * Do you have any health conditions that need accommodation or might affect your ministry? Please also list any allergies. If you are applying for a position with the Junior or Senior High please answer the following questions: Date of last Tetanus shot Insurance Provider (include ID# & Group) How long have you attended First MB Church? * If less than one year, please list previous church(es) attended in the last 5 years. Personal Beliefs In a few sentences, describe when and how you became a Christian. How has your faith grown since? * List any spiritual gifts, special training, experiences, or abilities that may be useful in Student and Kids' Ministry. * Please list your past ministry experience, where you served and for how long (the past 5 years)? * Background Information Have you ever engaged in inappropriate conduct of romantic, sexual, or abusive nature with a minor, or been accused, rightly or wrongly, of having done so? * Yes No Acknowledgements and AgreementsAffirmation of Accuracy: I affirm that all of the information contained in this application is true and correct to the best of my knowledge. I understand that I may be asked to speak confidentially with a staff member regarding any of my answers, and agree to do so. Authorization for Verification and Background Check: I authorize First Mennonite Brethren Church (First MB) to verify the information on this form and to conduct investigative inquires on my background to assess whether any reason exists that would suggest that I not be accepted for a Kids or Student Ministry position. These inquiries may include, but not be limited to, ID verification, criminal history background check, driving record check, and inquiries to references and government agencies. I authorize any individual, group, agency, or organization to give First MB any information (including opinions) that they may have regarding my background, character, and fitness for the ministry I waive any right that I may have to inspect any information about me obtained and maintained by First MB in connection with this application and my participation in Kids or Student Ministry. Release of Liability: In consideration of the receipt and evaluation of this application by First MB, I hereby release First MB and its representatives, as well as any outside individual, group, agency, or breach of privacy, that may at any time result to me, or anyone entitled to recover through me or because of their relationship to me, in connection with the preceding Authorization. Further, in consideration of First MB allowing me to participate in Kids or Student Ministry, I, for myself as well as for anyone entitled to recover through me or because of their relationship to me, hereby waive and release all right and claim for damage that may exist against First MB and its agents, employees, representatives, volunteers, successors and assigns (collectively, “the released Parties”), for any and all injuries or damages of any sort suffered by me arising out of my participation. I further agree that in the event any party or entity makes any claim against the Release Parties for injuries or damages arising out of such participation, I will indemnify, defend and hold the Released Parties harmless from any and all damages and expenses occasioned thereby, including attorney’s fees. Termination: I recognize that I have no right to participate in Kids or Student Ministry at First MB and that my participation may be terminated by First MB at any time for any reason or for no reason. I waive any right I might have to challenge such termination in any manner. Applicant's StatementI have carefully read and understand the contents of these "Acknowledgements and Agreements" and sign this document as my own act, recognizing that it is legally binding. Signature (Type Name to Sign) Date * For background purposes. By filling out this form you give permission for a background check.