KidzMin Youth Volunteer Application - Peninsula Community Chapel

Your name *

Email address *

Address

Phone number

Personal References

Please provide us two references: 1 from PCC and 1 professional reference (someone other than family who can speak to your character in work situations.)

PCC Reference #1 (if you are new to PCC, please list a reference from your previous church) *

First and Last Name

Personal Reference #2 *

First and Last Name

Church Activity & Experience

Please provide information on where you are involved at church:

Length of time attending PCC?

Length of time attending youth group?

What youth activities are you involved in (Sunday School, missions trips, SportsWorld, etc.)?

Please provide information on any childcare experience you may have:

List other areas of involvement at PCC or in the community:

Please provide us a brief personal testimony:

Availability:

Please provide an answer to the following questions:

Area of interest in serving: (check all that apply) *

Nursery (16 years of age or older)

Preschool

Elementary

45 (4th and 5th grade ministry)

Large Group Tech

Buddy Ministry

Please provide the date in which you could start serving:

Which service are you able to serve at?:

9:00 AM

10:45 AM

Code of Ethics

Please read over the following portion:

1. I desire to model Christ-likeness in all my behavior, especially as I serve in ministry to children at Peninsula Community Chapel. I aim to demonstrate my love for the Lord Jesus, my gratitude for His grace and forgiveness, and testify to the power of the Holy Spirit working in my life.

2.I desire to demonstrate respect, loyalty, patience, courtesy, and maturity.

3. I will treat kids of all races, religions, and cultures with respect and consideration.

4. I will not abuse kids in any way, including but not limited to: Physical abuse, Verbal/Mental abuse (humiliate, degrade, threaten, etc.), Sexual abuse (e.g. inappropriate touch, or exposure)

5. I will not use or tolerate profanity in the presence of children.

6. I understand that any violation of this Code may be grounds for dismissal, discipline, or other action by the Church.

Background Check Information

The following section has questions we ask each youth volunteer to answer before serving in KidzMin which serves as a background check.

Have you ever been arrested or convicted of a felony? *

Yes

If you answered yes above, please explain more here:

Have you ever been expelled from school? *

Yes

If you answered yes to the questions above, please explain more here:

Final Steps- Youth Electronic Signature

I understand that if I have questions about the Code of Ethics, any church policies, or any aspect of my service with Peninsula Community Chapel Children’s Ministry (aka “KidzMin”), I will contact the KidzMin Coordinator or Family & College Pastor for clarification and guidance.

I agree to follow the policies and procedures as outlined here—as well as to support the vision and mission of PCC and its Children’s Ministry.

By signing below, I indicate that I have carefully read the above and understand the contents. I also acknowledge that all of the information I have provided is true and complete.

Safety Training - Required prior to serving in KidzMin

Paste the following link into your browser :
https://www.pencomchap.com/kidzmin-volunteers.html

Scroll down to the KidzMin Safety Training Video
Password: kidzmin101.

Be sure to review the video and complete the Safety Training Quiz in order to obtain credit for the training.

Please leave your name below confirming you have seen this important step:

Parent/Guardian Verification and Consent

By signing below, I verify that the person listed above is a youth participant (age 18 or younger) representing our church or a ministry of our church as a volunteer. I also hereby certify that the above person has, to the best of my knowledge, no criminal conviction (felony or misdemeanor) record of:

 Violence against another person
 Sexual Crimes involving children, youth or adults
 Use, or distribution, of illicit drugs or controlled substance
 Property Crime

I understand that if I have questions about the Code of Ethics, any church policies, or any aspect of my service with Peninsula Community Chapel Children’s Ministry (aka “KidzMin”), I will contact the KidzMin Coordinator or Family & College Pastor for clarification and guidance.

I consent to allow my child to volunteer:

Parent/Guardian Name *

Parent Phone Number *

Electronic Signature of Parent *