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Adult Serve Application for CrossRoads Kids

We'd love to get to know you better, so please take a few minutes to complete this form.

Your name *

Last name

Email address *

Personal Information

Mailing Address *

Street, City, Postal Code

Phone number *

Phone type

Birthdate *

Gender *

Preferred Way to Be Contacted *

Are you a CrossRoads member or attendee of the church? *

I am a member

I am an attendee

I am neither

How long have you been attending CrossRoads? *

If less than 3 months where did you previously attend?

How long have you had a personal relationship with Jesus? *

Have you been baptized? *

Previous experience with kids: *

List any gifts, training, education or other qualifications that have prepared you to minister with children or youth.

Do you currently have a child in CrossRoads Kids that you would like to serve with?

Confidential Information

Answering yes to any of these questions may not necessarily preclude your involvement in ministry.

Are there any circumstances involving your lifestyle or background that would call into question your ability to work with Children, Youth and Vulnerable Adults? (e.g. use of illegal substances) *

Have you ever been convicted or found guilty of a criminal offence for which a pardon has not been granted (excluding minor traffic violations)? *

If you answered yes, please list offence(s) and the date(s) of conviction.

Have you ever been expelled from or had your employment terminated by any organization or employer for assault, violence or impropriety against a Child, Youth or Vulnerable Person (e.g. senior citizen or person with disabilities)? *

Have you ever been investigated by the Child Welfare Agency or any other organization for suspected child abuse? *

Have you ever been a defendant or respondent in a civil lawsuit or human rights complaint or legal proceeding involving Children, Youth or Vulnerable Adults? *

*In which you were alleged to have abused or engaged in violence, harassment or other immoral or illegal behavior or conduct.

Do you have any health concerns which could impact your ability to perform the functions of the volunteer position for which you are applying? (Please note such health concerns may not prevent you from holding the position for which you have applied) *

Do you have any contagious diseases or conditions of which we should be aware, and which we may need to take steps to protect against transmission should you volunteer at our organization? *

If you have answered yes to any of the above questions, please explain.

Serve Area Opportunities

Serving Area *

Check all that apply

Infants (birth to 30 months old)

Pre-K (2-4 Year Olds)

Kindergarten-Grade 4 Room Leaders

Grades 5-6 Room Leader

Baking Team

Mid Week Help

Kids Min Welcome Team

Special Event Team

From the serving areas above, what's your #1 preference? *

Service Times *

Preferred service you'd like to serve in

9 AM

11 AM

6 PM

References

Please provide three unrelated references. These references can be obtain from a pastor, employer, coworker, close friend or teacher.

Reference 1 *

First & last name of reference

E-mail *

Phone Number: *

Nature of Relationship *

Reference 2 *

First & last name of reference

E-mail *

Phone Number *

Nature of Relationship *

Reference 3: *

First and last name of reference

E-mail *

Phone Number *

Nature of Relationship *

I agree with the following statement: *

I give CrossRoads Church permission to check with my references on my ability to be a Serve in CrossRoads Kids. I love Jesus and understand that I need to be an example of Jesus to the kids and families that I am serving in all areas of my life. I understand that in order to serve, I must also be attending services in the Sanctuary consistently. I understand that any information I hear about a child or family must be kept confidential outside of CrossRoads staff. I will submit a Criminal Record Check and attend future CrossRoads Kids serve training events

Yes

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CrossRoads Church
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