Page 150 | Rejoice Lutheran Church

Welcome to our Youth Ministry Volunteer Application Site!

We are grateful for your interest in serving the children and youth of our congregation. Under our Child and Youth Protection Policy, all applicants are required to complete and submit this form, as well as, be subject to a background investigation. If you have any questions about this process, please do not hesitate to reach out to Pastor at pastor@rejoicelutheranchurch.org. Thank you, again!

Full Name (Required)

Date of Birth (Required)

Address (Required)

Phone Number (Required)

Is this mobile or landline? (Required)

Mobile

Landline

Email Address (Required)

Emergency Contact Name (Required)

Emergency Contact Phone: (Required)

Rejoice Lutheran Church Reference (non-family) (Required)

(Lack of reference will require an interview with the Child, Youth, and Family Coordinator)

What particular areas are you interested in helping? (Required)

This might include teaching or assisting with Funday school or Vacation Bible School, confirmation mentor, small group leader or any other area in which you're interested.

Preferred Age Group (Required)

You can select one or more.

Children

Junior High/Middle School

High School

Availability (Required)

(Days/times/how often)

Background Investigation Disclosures and Authorization

Please read and scroll to the bottom to complete and submit this form.

1. Disclosure Regarding Background Check on You

Rejoice Lutheran Church (‘the Company’) may obtain ‘Consumer Reports’ about you from a Consumer Reporting Agency to determine whether you will be permitted to take part in certain volunteer opportunities. A ‘Consumer Report’ is a Background Check report that may contain information regarding your criminal history, sex offender registry status, employment history, education history, driving history, ordinance violations, restraining order history, drug test results, and other information about you. It may bear upon your character, general reputation, personal characteristics, and/or mode of living.

2. Notice of Background Investigation Pursuant to Minnesota Law

You have the right, upon written request, to receive a complete and accurate disclosure of the nature and scope of any Consumer Report ordered by Rejoice Lutheran Church. A Consumer Reporting Agency must make this disclosure within five (5) days of receipt of your request or of the Rejoice Lutheran Church’s request for the report, whichever is later. The consumer reporting agency that is preparing a report on you is MinistrySafe, (MinistrySafe.com) at 6001 River Oaks Blvd., Suite 400, Fort Worth, Texas 76114, 833-737-7233.

Please check this box if you would like to receive a copy of a consumer report if one is obtained by Rejoice Lutheran Church.

3. Additional Notice Regarding Investigative Consumer Reports on You

Rejoice Lutheran Church (‘the Company’) may also request an ‘Investigative Consumer Report’ on you from a Consumer Reporting Agency. An ‘Investigative Consumer Report’ is a Background Check report generated through personal interviews with sources such as your neighbors, friends or associates. The Consumer Reporting Agency that may prepare an ‘Investigative Consumer Report’ on you for the Company is MinistrySafe, 6001 River Oaks Blvd., Suite 400, Fort Worth, Texas 76114, 833-737-7233. The information contained in an ‘Investigative Consumer Report’ may bear upon your character, general reputation, personal characteristics, and/or mode of living. Please be advised that the nature and scope of the most common form of ‘Investigative Consumer Report’ that may be ordered by the Company is an investigation into your employment history. During such an investigation, MinistrySafe may ask questions of certain knowledgeable individuals about your employment history and provide responsive information to the Company. Note

4. Authorization Regarding Background Investigation

I acknowledge receipt of the following separate documents (and certify that I have read and understood them): DISCLOSURE REGARDING BACKGROUND INVESTIGATION ON YOU (contained herein); ADDITIONAL NOTICE REGARDING INVESTIGATIVE CONSUMER REPORTS ON YOU (contained herein); NOTICE OF BACKGROUND INVESTIGATION PURSUANT TO MINNESOTA LAW (contained herein); A SUMMARY OF YOUR RIGHTS UNDER THE FAIR CREDIT REPORTING ACT (provided separately).

Authorization (Required)

I hereby authorize Rejoice Lutheran Church to obtain ‘Consumer Reports’ and ‘Investigative Consumer Reports’ about me to determine whether I will be permitted to take part in certain volunteer opportunities throughout the duration of my volunteer

Your Signature (type your full name) (Required)

By signing, you are submitting your youth ministry application. You also acknowledge both the receipt of required disclosures and authorize Rejoice Lutheran to initiate a background investigation.

Today's Date (Required)