This application is for all teens, 13 through 17 years of age after at least 6 months of active involvement at the church, for any position involving the supervision of children. This is not an employment application. The purpose is to assist in the creation of a safe environment for children who participate in the programs of Bethesda Community Church or use Bethesda Community Church, School, or Daycare facilities.









List all previous paid or volunteer work involving children. This would include all church and non-church paid or volunteer work with children. (List each church or organization's name and address, type of paid or volunteer work carried out, dates, and a contact person familiar with your work there.)

Because our church cares for our members and children, and desires to protect them, please answer the following questions. We understand that the answers to these questions may be private and deeply personal, and we will protect your privacy.

Please provide adult references. Include one work or volunteer reference (if available) and one personal reference. References must include at least one non-family member and one member of the opposite sex. Give complete mailing addresses, including zip codes and email addresses. Please contact your references and tell them an authorized Bethesda Community Church staff person will be contacting them to complete the application process.

Include Name, Address, and Phone Number.

Include Name, Address, and Phone Number.

RELEASE

VOLUNTEER SIGNATURE

Please Type Your Name as Your Signature

PARENT SIGNATURE

Please Type Your Name as Your Signature