One Day Fun Day 2023 Volunteers Wednesday, March 22nd / 9am–3pm Volunteer Registration Form *Denotes Required Field * Title Personal Information * Full Name * Address / City / Postal Code * Preferred Phone # ( ) - * Email * Birthdate Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 * Are you a student? Yes No * Grade * Gender Male Female Volunteer Positions Select position: Small Group Leader (aged 16+) Junior Leader (Grade 8+) Activity Leader Bathroom Assistant Security * Are you currently serving in a ministry at Cloverdale Baptist Church? No Yes Criminal Record Check * I am willing to consent to a Criminal Record Check if 18+ years old if CBC doesn't already have one on file, and I'll have it into our office by or before March 22, 2023. Spiritual History * How long have you been attending Cloverdale Baptist Church? * Do you regularly attend (two or more times a month)? Yes No * When did you accept Christ as your Saviour? Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 * Have you been baptized? Yes No * Date of baptism Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 List any gifts, training, education, or other qualifications that you believe you have, that have prepared you to minister to children * In a brief paragraph, please outline your spiritual journey Why would you like to be a part of our Summer Camp Ministry? Do you see yourself as a team player? Please explain: Do you see yourself as a leader? Please explain: Have you previously been involved with our summer camp? Yes No * What year? * In what capacity? Ministry Experience: Previous and Present Describe your previous and present ministry experience: References * Name of Reference #1 Email Name of Reference #2 Email Ability to Work with Children In order to provide a safe and secure environment for our church’s children and youth, we believe it is necessary to ask the following questions as part of our application process. All information will be kept in confidence by church leadership and the Safety & Risk Management team and will not be disclosed by the church unless required by law. Answering ’yes’ to any of the following questions may not necessarily prevent you from volunteering with the church. Thank you for your understanding. * 1. Are there any circumstances involving your lifestyle or history that could call into question your ability to work safely with children or youth in a Christian environment (e.g. use of pornography, illegal substances, etc)? Yes No * 2. Have you ever been convicted or found guilty of a criminal offence for which a pardon has not been granted (Note: This does not include minor traffic violations.) If ‘yes’ please list offences(s) and the date(s) Yes No * List offence(s) and date(s): * 3. Have you ever been expelled from or had your employment terminated by any organization or employer for assault or violence against any person, or for assault, violence or impropriety with children, youth or vulnerable person (e.g. senior citizens or persons with disabilities)? Yes No * 4. Have you ever been investigated by the BC Ministry of Children & Family Development or any other organization for suspected child abuse? Yes No * 5. Do you have any health concerns which could impact your ability to perform the functions or the volunteer position for which you are applying? Yes No * 6. Do you have any contagious diseases or medical concerns of which we should be aware, and of which we may need to take steps to protect against transmission should you volunteer at the church? Yes No Consent 1. In order to decide my suitability for volunteer ministry in this organization, I hereby give the designated leadership of Cloverdale Baptist Church consent to: Verify the information provided by me in this Ministry Personnel Application Form Contact the references and employers listed in this application Obtain and verify any information from them and any other persons that the church determines to be relevant to my application 2. I understand that in British Columbia a Criminal Record Check is legally required for anyone working with the Vulnerable Sector (children, youth and vulnerable adults). I therefore agree to complete a CRC and have it returned to Cloverdale Baptist Church. 3. I further grant Cloverdale Baptist Church the permission to perform an internet search on me and to review and consider any information found posted by me on the Internet. 4. I understand that if Cloverdale Baptist Church approves my volunteer application and later determines, in its discretion, at any time that I am not suitable for volunteer service in Cloverdale Baptist Church or for the volunteer position for which I am applying, the leadership may terminate my volunteer service or volunteer position for any reason without advance notice. 5. If Cloverdale Baptist Church approves my application for a volunteer position, I will sign any documents that the church requires and will at all time cooperate fully with the church leadership in the fulfillment of my duties and will keep all confidential information I encounter in my role as volunteer confidential. 6. If at any time I determine that for any reason I am unable to support or adhere to or follow the policies, procedures or doctrine of Cloverdale Baptist Church, I will inform the church leadership and will resign my volunteer position. Information received in this Ministry Personnel Application Form is confidential and is being gathered for the purposes of considering your application for volunteer ministry with Cloverdale Baptist Church and for assessing potential ministry opportunities for you in the future. * I hereby acknowledge that, to the best of my knowledge, the information contained in this Ministry Personnel Application Form is true and correct. Photography/Video * I GRANT permission for the use of my photo, image, or video captured during any of these events, including for promotional purposes, up to an end date of December 2026. Yes No Questions? Contact Pastor Dwight at pastordwight@cloverdalebaptist.ca
