Vineyard Kid's Volunteer Application - Vineyard Church Laguna Niguel

Personal Background

Phone number *

Address *

Gender *

Birthdate *

Marital status *

Household members

Occupation *

Work Phone Number

Are you CPR certified or have medical training? *

Do you speak another language(s)? *

Church History & Prior Experience

Do you have a personal relationship with Jesus Christ? *

Briefly describe: *

How long have you attended our church? *

Do you attend a home group or Bible study? *

List previous church name, address and phone number: *

How long did you attend? *

Please list any other church ministries you are currently involved in and the leader's name: *

Please list a leader at VCC who could act as a reference on your behalf? *

**This cannot be the children’s pastor or director of the children’s ministry

Availibility & Gifting

Please check the service times in which you are interested in serving: *

Sunday AM Service (9AM)

Wednesday Night Kids Connect (5:15PM)

What age/grade groups are you interested in serving? *

**You may choose multiple age groups

Nursery (newborn to walking)

Toddler

Pre-K/K

Kinder/1st Grade

2nd/3rd Grade

4th/5th Grade

Please describe what leadership and teacher/childcare experience you have had: *

**You may include any gifts, hobbies, or interests

Which of these roles/interests and fits you best? *

Teacher/teacher assistant/teacher substitute

Worship

Arts/crafts/performing arts

Games

Service Coordinator (assists all classes, teachers and kids as needed)

Events (Art camp, movie Nights, CR8 Camp, Beach Days etc)

Class Helpers (love on kids, engage 1 on 1, assist as needed, non-teaching role)

Special needs children

Pastoral (prayer, crisis management, minister to children individually)

Set up/clean up (signs, tables etc)

Other

Do you have a unique skill, talent or special interest in an area that you could share with our kids?

(Ex. Worship leading, drama, puppets, etc.)

How often would you like to serve? *

**Weekly

2 times a month

Once a month

Only as needed

Special events only

Other

Is there anything else you would like us to know?

PROTECTION CLAUSE

The following questions are necessary to ensure a safe and secure environment for our children. The
information revealed here is held in strictest confidence by our leadership staff. Answering "yes" to any
of these questions may not necessarily exclude you from ministry at Vineyard Community Church.

Do you have any communicable diseases or health problems? *

Yes

No

Do you have any communicable diseases or health problems? *

Does your physical or mental health limit your activities or ability to work with children? *

Have you ever been hospitalized or treated for alcohol or drug abuse? *

Have you ever been convicted of or pleaded guilty to a felony? *

Do you have any circumstances involving your lifestyle or background that would call into question your ability to work with children, such as cohabiting as an unmarried couple? *

If you answered "yes" to any of the above questions, please explain: *

**You may discuss your response with a church pastor rather than answering it on this form.

Personal References

Is there a leader here at Vineyard Community Church (home group leader, ministry leader, etc.) who would provide a personal recommendation ?

**If yes, please provide entire name

Please provide us with a local personal reference: *

**Must be over 18 years of age and not family
**Include first and last name

Phone number *

Address *

Relationship: *

Number of years you have known this person: *

Agreement & Signatures:

The information contained in this application is correct to the best of my knowledge. I authorize any
references, churches, or other organizations listed in this application to give you any information they
may have regarding my character and fitness for working with children and I release all such references
from liability for any damage that may result from furnishing such evaluations to you.

Applicant's Digital Signature: *

Today's Date: *