VBS Volunteer Registration - Teens & Adults - St. Luke Catholic Church

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First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.
Date of Birth REQUIRED Please fill out this field. Please enter valid data.
Street Address Please enter valid data.
City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.
Primary Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
Email REQUIRED Please fill out this field. Please enter an email address.
Are you a registered member at St. Luke's? REQUIRED Please fill out this field.
T-Shirt Size: AS AM AL AXL A XXL
Did you help previously with VBS? Yes No
Safe Environment Agreement
- Diocesan policy requires all adult volunteers (18 & up), who work with children, attend a Protecting God’s Children workshop, be fingerprinted, and have a background check. Additional fingerprints/background checks AND the A Plan to Protect God's Children 4.0 onine training are requested after every 5 years. Teen volunteers (14-17) are required to complete the Healthy Relationships for Teens 2.0 onine training.
Do you agree with these requests? Yes No
ADULTS ONLY - Have you attended a "Protecting God's Children" workshop? Yes No
ADULTS ONLY - Have you completed a background and fingerprint for the Diocese of St. Augustine within the last 5 years? Yes No
TEENS ONLY - Have you taken the "Healthy Relationships for Teens 2.0" online training? Yes No
Volunteer Preference VBS Director Director's Assistant Music Director Music Assistant Craft Leader Craft Assistant Games Leader Games Assistant Bible Leader Bible Assistant Group Rotation Leader Group Rotation Assistant Skit Director Music Teen Helper Craft Teen Helper Group Rotation Teen Helper Snack Helper First Aid Station Other
Do you agree to attend all required training sessions and meetings? Yes No
Comments:
Without compensation, I hereby grant permission to the Catholic Diocese of Saint Augustine to use and reproduce photographs and/or video taken of my child. These photographs may be used for news and editorial purposes in publications and other electronic reproductions (websites and video) and/or brochures. In addition, I grant my permission to alter the same photos without restriction and to copyright the same. I hereby release the photographer, the journalists and the publications or media outlets they represent, as well as, the parish/church and/or school involved. The Bishop of the Diocese of St. Augustin, a corporation sole, the Catholic Diocese of St. Augustin and all of their employees and agents, from all claims and liability relating to said photographs.
I Agree Please select this field.
To my knowledge, my child is in good health, and I assume all responsibility for the health of my child.

EMERGENCY MEDICAL TREATMENT
In the event of an emergency, I hereby give permission to Diocese of St. Augustine's employees, volunteers, or representatives to seek medical treatment for my child above named.

In the event that I cannot be reached in an emergency, I hereby give permission to the physician selected by the Diocesan representatives or volunteers to hospitalize secure proper treatment for, and order injection and/or anesthesia and/or surgery for my child above named.
I Agree Please select this field.
Signature: REQUIRED Please fill out this field. Please enter valid data.
Date: REQUIRED Please fill out this field. Please enter valid data.

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