Applying to Volunteer with Children / Youth

Thank you for your interest in volunteering with our children and students!

We require all volunteers and staff to read and adhere to our Child Protection Policy, submit a background check through NCSI, as well as fill out a Children’s Volunteer application form. Please follow the steps below:

Download and read our Worker Selection and Child Protection Policy in its entirety. You may read this policy here: Worker Selection and Child Protection Policy (Click to download).
Submit a background check using New Hope’s National Center for Safety Initiative’s Portal (Click Here to enter portal). Completed background checks are processed externally by NCSI and summaries are sent to Ben Tietje for review.
After steps 1-2, submit a Children’s Volunteer Application Form below. This form will be emailed to Pastors Ben & Matthew. If you are uncomfortable submitting your Volunteer Application Form online, please email Ben Tietje (ben@villagepca.com) to receive a hard copy.

Children & Youth Volunteer Application Form

I have read the Child Protection Policy in its entirety, and agree to adhere to it:

Yes

Name

First Name

Last Name

Present Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Home / Mobile Phone

(###)

###

####

Work Phone

(###)

###

####

Date of Birth

YYYY

Sex

All addresses you have lived in the past ten (10) years, and dates

Have you ever been convicted of or pleaded guilty to a crime involving sexual misconduct?

If yes, please explain:

Have you ever been sued in a civil action where the allegations included sexual misconduct?

If yes, please explain:

Please provide the name and phone number of three (3) references:

Statement of Agreement

I confirm that the information contained in this statement is correct to the best of my knowledge. I authorize any references listed in this statement to give you any information (including opinions) that they may have regarding my character and fitness for working with children or youth. In consideration of the receipt and evaluation of this statement by Village Presbyterian Church, I hereby release any individual, church, youth organization, charity, employer, reference, or other person or organization, including record custodians, both collectively and individually, from any and all liability for damages of compliance or any attempts to comply, with this authorization. I waive any right that I may have to inspect any information provided about me by any person or organization identified by me in this statement. Should I become a volunteer in the children’s ministry or youth ministry at Village Presbyterian Church, I agree to be bound by the policies and procedures of Village Presbyterian Church; to refrain from improper conduct, as defined by this policy and Village Presbyterian Church, and to follow any guidelines or procedures of the safety officer, ministry leaders, or the staff of the church, in the performance of my services on behalf of the church. I understand and agree that screening, approval, and possible investigation and reporting pertaining to child care are by nature an inexact science, are fallible and imperfect, and necessarily involve and require discretion on the part of Village Presbyterian Church personnel, and I hereby waive all potential claims of libel or slander or other cause of action that may hereafter arise associated with any aspect of those processes or my involvement with child care at or associated with Village Presbyterian Church. I further state that I have carefully read the foregoing release and know the contents thereof and I sign this release as my own free act. This is a legally binding agreement which I have read and understood.

I AGREE TO THE ABOVE STATEMENT OF AGREEMENT - Digital Signature (type full name):

I authorize the church, at its discretion, to conduct or to employ outside agencies to conduct, a criminal background check - Digital Signature (type full name):

Date of digital signature:

YYYY