Volunteer Annual Renewal Application - Minor
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Personal Information
Since submitting your previous application, have you:
Confidential Information
Please answer "yes " or "no" to the following questions.  
1. Have you ever used illegal substances or abusively used legal but addictive substances including alcohol)?
2. Been arrested for any reason, or been convicted of or pleaded no contest to any crime?
3. Been arrested or prosecuted for child abuse, physical assault or sexual assault of any nature?
4. Been known by any other names?
5. Are there any health issues, such as allergies, or a physical condition that may limit your serving in a ministry at Christ Church?
*If you answered "yes" to any of the above, please explain
Authorization
IF UNDER 18, PARENT MUST COMPLETE THIS PORTION OF THE APPLICATION. BY COMPLETING AND SUBMITTING THIS FORM, I AGREE TO THE FOLLOWING:
1. I am the parent or legal guardian of the person named below (The "Minor"), who is volunteering to serve in the ministry(ies) checked below. I understand that CCOB intends to take reasonable precautions to assure the safety and security of volunteers, but acknowledge that, even with such precautions, there is a possibility of injury or death or loss of or damage to property.
2. I give my permission for the Minor named below to volunteer for the ministry(ies) indicated.
3. In consideration of CcOB's allowing the Minor to participate. I release CCOB and its members, officers, directors, employees and agents from any liability for injury to or death of, or damage to or loss of personal property belonging to, the Minor occurring in connection with his/her volunteer service.
4. Should an accident or other medical emergency occur in connection with his/her volunteer service. I authorize a physician selected by the representative of CCOB to approve any medical treatment deemed necessary, including but not limited to trauma treatment, administration of medication, hospitalization, anesthesia and surgery.
5. I also agree that any photographs, video recordings and voice recordings of the Minor taken in connection with his/her participation in any Christ Church event will be the property of Christ Church of Oak Brookand may be used by Christ Church of Oak Brook for any promotional and informational purposes it deems appropriate. Possible uses include but are not limited to exhibits, displays, DVDs and CDs, printed collateral, Web pages and external periodicals.
6. This release will be valid for one year from authorized signature's date of this document
7. I have read, understand and promise to follow and obey the Christ Church's Protection Policy. I promise to report immediately any deviations (whether personally observed or heard about) from the Protection Policy to the Director/Pastor of my ministry area, the Senior Pastor or any member of the Management Team. View Protection Policy









 

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