Volunteer Application for Karis Kids

Warning : Confidential Information--Read Carefully! This document contains confidential information that may be reviewed only by Tony Boes (Lead Pastor of Karis JC), and at his discretion, the Karis Eldership team and the leadership of Karis Kids or Karis Youth. No other person is authorized to review this document. Persons who review, duplicate, distribute, or disclose any portion of this document without authorization may face one or more of the following consequences: (1) Termination of employment, if an employee. (2) Dismissal from any official position within the church, if a volunteer. (3) Possible criminal liability. (4) Possible civil liability.
Part I: Personal Information
Name *
Name
Are you a member of Karis? *
Part II: Personal References
Every applicant for participation in Karis Kids, Karis Youth, or the Safety and Security team must provide two personal references. A Karis Elder will contact these references. If you have been a member of Karis for less than six months, please list:
  1. A pastor or church leader from the church you most recently attended
  2. A person with whom you have worked/served in the past who knows you well. (If you have served in children's ministry in the past, please list someone who served with you in that context.)
If you have been a member of Karis for more than six months, please list:
  1. An elder, small group leader, or other church leader who knows you well
  2. Another member of Karis who knows you well and can attest to your suitability to work with children.
Reference #1 - Name *
Reference #1 - Name
Reference #1 - Phone *
Reference #1 - Phone
Reference #2 - Name *
Reference #2 - Name
Reference #2 - Phone *
Reference #2 - Phone
Part III: Health Information
Because of the nature of this ministry, it is essential that we ask the following health questions. Affirmative answers will not automatically disqualify you from serving.
Do you have any communicable diseases or infections such as TB, Hepatitis B, AIDS, MRSA, etc.? *
Have you ever been hospitalized for an issue or incident related to your mental health? *
Part IV: Personal History
The following questions are designed to help us provide a safe, loving, and secure environment for all volunteers and Karis attendees. All information provided in this section of the application will be treated confidentially and will not be disclosed to others outside the staff immediately involved in the ministry screening process unless that staff deems that disclosure to the elders is necessary for the protection of the those participating in our programs. If any of the following questions is answered "yes", an elder will speak with you in private. This conversation will help to determine whether pastoral assistance or counseling may be needed, and whether that issue has any bearing on your ability to serve. If for any reason you prefer not to answer these questions through this form, simply leave them blank, and an elder will talk with you personally and privately.
Have you ever been accused of, participated in, plead guilty to, or been convicted of child abuse, child neglect, or any other crime against a minor?
As a teenager or as an adult, have you ever touched a child in a sexual or abusive manner?
Have you ever been arrested, convicted, or plead guilty to a crime other than minor traffic violations?
Have you deliberately and repeatedly viewed pornography in the past three years?
Are you currently or have you ever struggled with substance abuse? This includes alcohol, illegal drugs, or prescription drugs.
I would like to speak to an elder regarding my own experiences or questions related to issues of abuse.
Far too many souls have been wounded by physical, psychological, and sexual abuse. If you are hurting, or just need help processing your own experiences, please check this box. If you have any concerns or questions related to Karis' efforts to protect our children, please check this box.
Part V: Applicant's Statement
The information contained in this application is true and correct to the best of my knowledge. I authorize Karis Church to contact any references or organizations listed in this application. Furthermore, I authorize such references and organizations to provide Karis with any information they may have regarding my character and fitness for serving. I release Karis, all of its agents, and all such references and organizations from any and all liability for any damage that may result from furnishing such evaluations to you, and I waive any right that I may have to inspect references provided on my behalf. I further state that I have carefully read the foregoing release and know and understand the contents thereof. I sign this release as my own free act. This is a legally binding agreement that I have read and understand. *