Adult Volunteer Form

2017 VACATION BIBLE SCHOOL

ADULT VOLUNTEER REGISTRATION FORM

This form is only for adult volunteers. Helpers under 18 years of age must have a parent or guardian complete the child registration form.
Are you over 18 years of age?*
If you're not over 18, click HERE and have your parent register you as a helper.
Volunteer Information
Name*

First NameLast Name
Gender*

MaleFemale
Do you have Safe Church Training for Children and Youth?*
(Safe Church training is not required, but this information will help us assign our volunteers as needed.)
Do you have any allergies, chronic illness, or medical conditions? Do you have an inhaler or epi-pen? Please type "yes" or "no". If yes, please describe.*
Phone during VBS Hours*

Area CodePhone Number
Alternate Phone No.*

Area CodePhone Number
E-mail*
Home Address*

Street Address

Street Address Line 2

CityState

Zip Code
Emergency Contact Information
Emergency Contact's Name*

First NameLast Name
Relationship*
Phone During VBS*

Area CodePhone Number
Alt. Phone Number*

Area CodePhone Number
Emergency Contact Address*

Street Address

Street Address Line 2

CityState

Zip Code
How would you like to help?

(Please note, this is for informational purposes only. We will assign volunteers based on need.)
I am interested in the following jobs:

Activity-Specific Leader (Music, Art, Games, etc.)Kitchen helperSetup / CleanupGroup LeaderWherever I am needed!
What activity-specific areas interest you?
When can you help us?
Select one or more dates:*

Sunday, August 6th (Setup)Tuesday, August 8thWednesday, August 9thThursday, August 10thFriday, August 11thCleanup
Anything Else You'd Like to Share?

(Hidden talents, ideas for VBS, etc.)
Other:
Liability and Medical Release

I understand and assume all risk and hazards associated with the various activities sponsored by St. Luke’s Episcopal Church as part of the 2017 Vacation Bible School Program.and do hereby release and agree to hold harmless St. Luke’s Episcopal Church and associated volunteers, agents, and employees from all liability for personal injury or property damage for all actions taken in good faith during Vacation Bible School activities. I understand that photographs of me may be taken and give permission for use of these photographs in promotional materials by either church, including on church websites and brochures. In the event I cannot communicate in an emergency, I hereby give my permission to the leaders of Vacation Bible School to secure appropriate medical services and for the physician(s), hospital, or medical service(s) selected by the leaders of Vacation Bible School to hospitalize, treat, and to order injection, anesthesia, or surgery for myself as named above.
Confirmation

BY ACKNOWLEDGING AND ENTERING MY INITIALS BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
ENTER INITIALS*
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