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Volunteer Registration

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Faith Lutheran Church

Location

602 S. 14th St.

Adel, IA 50003

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Contact DCE Madi Aeikens:

701-238-5222

dcemadi@faithadel.com

Tell us about yourself:

What positions are you interested in?

At least one choice is required.

First Name

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Last Name

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Address 1

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City

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State/Province

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ZIP/Postal Code

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Phone

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Alternate phone

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Date Of Birth

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Shirt Size

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Under 18

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For youth and adult helpers

Please complete all sections that apply. Volunteers age 18 and older should complete the background check section below.

For Volunteers Under 18

Parent / Guardian Name

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Parent / Guardian Phone

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Parent / Guardian Email

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Emergency Contact: Name, Phone, Relationship

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School/ Grade

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Allergies

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Medical Concerns

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Parent/ Guardian Permission:

I give permission for my child’s image to be used in Faith Lutheran Church materials. In the event of an emergency, I authorize Faith Lutheran Church to seek medical treatment for my child if I cannot be reached. I also give permission for my child to volunteer at Faith Lutheran Church VBS and to participate in related activities.

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For Volunteers Age 18 and Older

Please Provide: Date of Birth, Driver's License/State ID, State Optional: Employer, Occupation, Best time to Reach you.

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Have you previously volunteered with children or youth ministries?

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Background Check & Volunteer Statements (Age 18 & Older)

Authorization:I authorize Faith Lutheran Church, or its designated agent, to conduct reference and background checks, including criminal history and sex offender registry screening, in accordance with applicable laws.

I certify that the information provided is true and complete. I understand that false information may result in denial or removal from volunteer service.

I affirm that I have not been convicted of, nor pled guilty or no contest to, any offense involving abuse, neglect, or misconduct with a minor.

Reference Name, Phone/Email, Relationship

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Availability

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Comments

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