Volunteer to Help in the Nursery

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Thank you for volunteering to work in the nursery. The completing of this form does not guarantee a position in the nursery ministry. Someone from Lighthouse Baptist Church will be contacting you for some further information.

First Name *

Last Name *

Middle Name *

Address *

Date of Birth *

YYYY

Cell Phone *

Secondary Phone *

Are you a member of Lighthouse Baptist Church? *

Yes

List any experience working with children *

List any Lighthouse Baptist Church ministries in which you are involved *

List previous residence in the last five years (City and State) *

The statements below are part of the process to help provide a safe and secure environment for our children. Checking the boxes on any of these statements does not automatically disqualify you from service. Checking the box is equal to answering yes. *

I was the victim of child abuse while a minor

I have had experiences that might make it difficult for me to minister to children

I have been accused or convicted of a misdemeanor or felony

I use illegal drugs or have used them in the past

I have been treated for or I struggle with alcohol or substance abuse

I have been charged with child neglect or abuse

I have health issues that could place children at risk

I object to a criminal background check

None of these statements apply to me

Required

By clicking "I agree" I understand that the information I have provided may be verified, if necessary, by contacting persons or organizations that may have information concerning me. I hereby give permission for Lighthouse Baptist Church to have screening performed on my behalf. I hereby release and agree to hold harmless from liability any person or organization that provides information. I also authorize Lighthouse Baptist Church to submit a background check for criminal activity. I verify that the information I have provided is accurate and I understand the personal information I have given will be held confidential by the church staff. *

I agree

Required

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