Valid From June 2017 - September 2018

CHILDREN’S MINISTRY■YOUTH APPLICATION

This application is to be completed by any youth (under 18 years old) desiring to serve in any position inthe Children’s Ministry. All information is held in confidence by the VillageBibleChurch staff.

Full Legal Name______Social Security #______

Last First Middle

Address______

StreetCity Zip

Birthdate______/_____/_____Daytime Phone_(_____)______Cell Phone_(_____)______

Email______Best way to contact you: Email_____Phone_____ Text____ (Daytime____Evening____)

This Section is to be filled out by your parent/guardian

Photo Release: I give permission for my child to be photographed and/or videotaped for future promotional materials

including website postings. I do so without expectation of compensation and with the understanding that these

photographs and videotaped images will be used exclusively by VillageBibleChurch for its publications, website, and

publicity purposes. Please Check: □Yes □No

Medical Release:In the event of an emergency, I authorize those working on my behalf of Route 66 ministry to seek

and obtain medical care and give permission in releasing our medical information for the safety and well-being of my

child.

______

Parent/Guardian Signature Date

Do you have Health Insurance?□Yes □No

Name of Insurance Company: ______Policy # ______Group # ______

Authorization Phone Number (if required for treatment) ______

  1. What is your definition of a Christian? ______

______

  1. Briefly share when and how you became a Christian.______

______

______

  1. How long have you attended Village Bible Church? ______

How often do you attend a worship service? ____Weekly___Twice a month____Occasionally

  1. What small group/Sunday school classes are you involved in? ______
  1. What activities/ministries of our church are you presently involved in? ______

______

  1. What leadership/volunteer experience have you had with children? List all previous church work or other work involving children and youth. (Identify place and type of work-list supervisors.) ______
  1. Why do you desire to serve in the Children’s Ministries Department? ______

______

  1. Have you ever been accused or convicted of physical or sexual abuse of children? ____Yes____No

Haveyou ever been accused or convicted of possession/sale of controlled substances or driving under the influence of alcohol?____Yes____No

Are there any circumstances in your lifestyle or your background that would call into question your ability to serve with children? _____Yes____No

If you answered “Yes” to any of the three questions above please explain.______

______

  1. If you attended VBC less than one year, please list prior church attended and a person who will know you at this church.

Church Name ______Phone ______

Reference Name ______Phone______

  1. Please give 3 personal references other than a relative (if possible, someone from this church).

Name______Relationship______

Phone______Email______

Name______Relationship______

Phone______Email______

  1. I am interested in serving: (indicate time and ministry preference)

□ Sunday 9:15AM□ Sunday 11:00AM□ Wednesday 6:30PM□ During the Week

NurseryElementary Other Opportunities

□ 0-18 months□K-3rd Grade □ Substitute Toddlers □ 4th-6thGrade □ Information Table

□ 18 months-2’s□Kids Worship□ Assist Special Needs Child

Preschool□ Décor Team

□ 3’s, 4’s & 5’s□ Home Crafter

□ Party Coordinator

The information contained in this application is correct to the best of my knowledge. I authorize any references or churches listed in this application to give you any information that they may have regarding my character and ability to serve in Children’s Ministries. I release references from liability for any damage that may result from furnishing such evaluations to you.

Should my application be accepted, I agree to be bound by that leadership and policies of Village Bible Church and to refrain from unscriptural conduct in my service to the Lord here at the church. I will strive for excellence in all that Ido within the Children’sMinistries Department.

______

Applicant’s Signature Date

Village Bible Church Children’s Ministries ● 12671 Buaro Street ● Garden Grove, CA 92840 ● 714-537-0669