Student Ministry Leader Application

Name

Gender

Female Male

Address

Home Phone

Mobile Phone

Age

Medical Number

Allergies we need to be aware of

Medical Conditions or Medication we need to be aware of

References if attending LSCF for less than 6 months (should not be family members or other youth leaders)

1. Friend (Name and email address):

2. Church Leader (Name and email address):

Personal Questions

Have you ever been convicted of a criminal offence, in any country?

Yes No

Have you ever been found guilty (or plead guilty) to an offence involving the abuse of a child, in a court either inside Manitoba or outside Manitoba?

Yes No

In a paragraph or two please answer the following questions

Please describe how you became a Christian, and where you see yourself now in your spiritual journey.

How have you been growing in your relationship with Christ? What has been influencing you to grow? Who has impacted you?

What qualities or gifts do you bring to the Student Ministry team?

Do you have a church home? If so, what is it? Also, please give us a brief history of churches you have attended regularly in the past and any ministries in which you served.

The information contained in this application is correct to the best of my knowledge. I authorize any references or churches listed in this application to release any information they may have regarding my character and fitness to work with children or youth. I release all such references from liability for any damage that may result from furnishing such evaluations. I will read, understand and agree to abide by the Mennonite Brethren Safe Place Policy for Children’s Ministry before engaging in ministry. I consent to having a Criminal Record Check with vulnerable sectors verification.

yes

Parent/Guardian Information (if under 18)

I hereby consent to let my child, to participate in La Salle Student Ministry hosted by La Salle Community Fellowship.

I consent that photographs or video footage may be publically taken of the minor by ministry leaders, for ministry purposes only (which may include posting to social media and/or the ministry website). Media consent may be withdrawn by me at anytime, upon written notice.

Message to parents: Your child will be cared for as if s/he were our child. It is understood that caution will be taken by those persons in charge to prevent injury, but neither those in charge nor the church shall be held responsible in case of accident.

Parent/Legal Guardian Name

Parent/Legal Guardian Mobile

Parent/Guardian Birthdate (to confirm identity) DD/MM/YYYY

By typing your full name above and clicking submit you are electronically giving consent for your child to participate in this program.

Description

Please fill out this form and click submit.

Student Ministry Leader Application

Description

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