Volunteer Application & Screening Release

Ministry Preference

Host Team LifeYouth LifeKids LifeGroups Operations Team Production Team

Legal Name

Address

Phone

Gender

Female Male

Employer

Employer's Phone

T-Shirt Size

Are you a follower of Jesus Christ?

Yes No I'd like to be

Tell us a little about how you came to follow Jesus?

Verification

Excluding traffic related offences, have you ever been accused or convicted of criminal activity, or entered a plea of guilty or no contest to a criminal offence of any kind?

Yes No

Have you ever been accused or convicted of sexual misconduct, or entered a plea of guilty or no contest to abuse or sexual misconduct?

Yes No

Are you aware of any traits or tendencies that you possess that could pose any threat to children or youth?

Yes No

Staff Initials

Release Agreement's

Please type in your initials for each statement to indicate that you understand and agree with each statement.

I recognize that LifeNorth.Church is relying on the accuracy of the information I provide on this application. I attest and affirm that the information I have provided is absolutely true and correct. Please Initial:

I authorize LifeNorth.Church to contact any person or entity listed on this application, and I further authorize any such person or entity to provide the organization with information, opinions, and impressions relating to my background or qualifications. Please Initial:

I voluntarily release LifeNorth.Church and any such person or entity listed on this application from liability involving the communication of information relating to my background or qualifications. Please Initial:

I understand that I am entitled to a complete and accurate disclosure of the nature and scope of any consumer report on me. Please Initial:

I acknowledge that I am volunteering my time and efforts in service for Christ through the ministries of LifeNorth.Church, and that I will receive no monetary compensation or insurance benefits for my time or services performed. Please Initial:

I grant to LifeNorth.Church the right to make photo, video, and audio recordings of me (“Recordings”) as well as the perpetual, world-wide right to record, re-record, copy, edit, reproduce, publicly display, perform and distribute the Recordings in any way consistent with LifeNorth.Church’s ministry, including use on the Internet. I waive the right to inspect or approve the finished product wherein the Recording appear. Please Initial:

Please note the following release does not apply to any personal, professional or other project/work that is unrelated to LifeNorth.Church. Any work that I have created in my role/capacity as a volunteer for LifeNorth.Church in the past, present or future, recorded in any form (“Creative Work”) is for ownership of LifeNorth.Church and is considered a “work made for hire”. If for any reason, the work related to my volunteer service for LifeNorth.Church is determined at any time not to be a “work made for hire,” I agree to assign and do assign to LifeNorth.Church all right, title and interest to the Creative Work. Please Initial:

LifeNorth.Church wishes to maintain in confidence all information including marketing information, data, technology and research strategies, trade secrets inventions and knowhow disclosed by LifeNorth.Church to me, directly or indirectly, in written, oral or other tangible forms. In this regard, I agree that I will not disclose the confidential information and/or trade secrets with others without prior written consent of LifeNorth.Church, both during or after my volunteer service. Please Initial:

I acknowledge and accept the risk of physical injury that could occur from my participation as a volunteer. Except for gross negligence on the part of LifeNorth.Church, I accept personal financial responsibility for any bodily or personal injury sustained while I am volunteering. Further, I release and agree to indemnify and hold harmless LifeNorth.Church, and its officers, directors and representatives from any liability, injury, damage, loss, accidents, delay or irregularity related to being a volunteer for LifeNorth.Church. Please Initial:

I authorize LifeNorth.Church to conduct a background inquiry that may include public records and personal reference.

Yes No

Signature (Please type in your signature to indicate your agreement.

Date

Volunteer Application & Screening Release

Description

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