EmailMe Form - Mobile Day Camp Volunteer Registration Form

Name *

First Last

Address *

Street Address City State / Province / Region Postal / Zip Code Country / Region

Phone *

### - ### - ####

Email *

Email will be our primary means of communication.

Will you be at least 16 years old by the time you are volunteering? *

Yes

No

Birthday *

MM / DD / YYYY

Which Mobile Day Camp location do you want to volunteer with?

Select Location *

Anything else we should know?

Health Information

Please provide us with some basic health information in case of injury or emergency.

Do you have any health concerns that we should know about? (ex. severe allergies)

Healthcard Number with Version Code

Criminal Records Checks

NOTE: All Volunteers must be at least 16 years of age before the date of volunteering.

All Volunteers 18 years of age or older must have a Criminal Records Check submitted to the church.

All volunteers, of any age, must complete the following Voluntary Disclosure Statement.

Do you have a criminal records check on file with the church? *

Yes

No

Voluntary Disclosure Statement

By signing this document, I declare that within my lifetime I have not been convicted of a crime of any kind and that if a criminal records check were to be done on me, the results would come back stating that I do not have a criminal record of any kind.

Volunteer's Name to Sign *

Parent's Name to Sign if volunteer is under 18 years of age.

Date *

MM / DD / YYYY

If a confirmation page does not appear after you click "Submit Application," scroll up to see if you filled in all of the required fields.