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Volunteer Registration

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Westminster Presbyterian Church

Location

2040 Washington Rd

Pittsburgh, PA 15241

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Contact Faith Kemmler:

412-407-3774

kemmler@westminster-church.org

Tell us about yourself:

What positions are you interested in?

At least one choice is required.

Registration forms must be filled out by a parent/guardian of the child. Forms filled out by other people will not be considered valid.

Check above the volunteer opportunities you are interested in. You can click more than one option. Please note that we may need you in a different area than you selected. If this is the case, we will contact you directly. If you have questions about what these positions entail, email Faith Kemmler at kemmler@westminster-church.org

All volunteers over 18 years are required to submit 3 clearances per PA state law. They are ChildLine Child Welfare Clearance, PA Residency Affidavit OR FBI Fingerprints, & PA State Criminal Record Check. If your clearances are from JUNE 2021 OR OLDER they are expired and will need to be redone.

Please submit clearances and questions to Laura Ecklin at ecklin@westminster-church.org

First Name

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Last Name

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All news and updates will be sent via email - please check your inbox and spam folder regularly.

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Address 1

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Address 2

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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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Shirt Size

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Availability

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Do you have a friend you would like to request to be paired with? This is a request only and not guaranteed.

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If you want to be a crew leader, do you have an age group you prefer?

Multiple selections are allowed.

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If you are under 18 years of age,

please answer the following questions

Date Of Birth

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Allergies

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Parent Email

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Emergency Contact Name & Relationship

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Emergency Contact Phone

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Grade Entering Fall 2026

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PHOTO/VIDEO RELEASE

I understand that by participating in Westminster Presbyterian Church worship and activities, I/my child(ren) may be photographed and/or videotaped. I hereby assign and authorize the producer, Westminster Presbyterian Church, the rights (all rights) in and to such videotape and photography. I also authorize said producer, without limitation, the right to reproduce, copy, exhibit/publish, and distribute any such videotape and/or photographs, and expressly waive any rights or claims I may have against Westminster and/or any of its Affiliates, Subsidiaries, or Assignees except as outlined in this contract.

CONSENT, RELEASE, and INDEMNITY

I understand that participation in any events at Westminster Presbyterian Church can present a risk of harm to the participant and that I have a personal responsibility for assuming any and all medical, hospital, and related expenses that may result from my own or my child(ren)’s participation in any of events at Westminster Presbyterian Church. I hereby release Westminster Presbyterian Church, affiliated and sponsored organizations, and its personnel, and agree to indemnify and hold harmless the church and its personnel from and against any liability of any nature whatsoever for any injury to myself and/or my child(ren) resulting or arising in any way from my/their participation in any events offered through Westminster Presbyterian Church. I understand WPC provides no medical coverage. Submitting this form acts as your signature for the above statement and states that all above information was completed accurately by the parent or legal guardian of the child(ren) aforementioned on this form.

Comments

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