Youth Ministry Volunteer Application

The information on this form is to be viewed by the Youth Ministry and the relevant office staff only.
Please list: Church Name, Pastor's Name & Years Attended
It should be understood that submitting personal information over the internet carries with it a certain level of access to sensitive information. We do our best to keep this information for youth ministry staff only, but if you would prefer to submit the answers to the following questions in paper form please check the appropriate box.
Questions
References

Please list two non-related individuals who would be able to give an objective evaluation of your character and capabilities.

Please include: name, phone, address, email, your relationship to the reference and how long you've known them.
Please include: name, phone, address, email, your relationship to the reference and how long you've known them.

I authorize references from individuals listed in this application to give Knox Presbyterian Church any information including opinions they may have regarding my character and fitness for work with minors. I release individuals and organizations that provide any information about me from any and all liability for damages of whatever kind or nature in regard to their release of information. I waive any right I may have to inspect any information provided about me by those identified on this application. A copy of this release may be sent to any of the references I have supplied.

I understand that any release/disclosure of information carries with it the potential for an unauthorized redisclosure and the information may not be protected by Federal Confidentiality Laws. I understand that I have waived my right to inspect any information provided by my references and have released all individuals and organizations from any and all liability for damages in regard to their release of information about me. I certify that the information I have provided in this application is correct to the best of my knowledge. I understand that this application will be kept strictly confidential.

This application remains in effect even if the volunteer changes their area of service. If there are any changes in the above information, the volunteer should inform the Youth Ministry Director.