The information contained in this application is correct to the best of my knowledge. I authorize, by my signature below, any of the churches, organizations or references I have listed to give you any information (including opinions) that they may have regarding my character and fitness for youth work. I also submit to and authorize Algonac Church of Christ to contact law enforcement officials to screen local and national records using my name and all related personal data I have provided on my own.

In consideration of the receipt and evaluation of this application by Algonac Church of Christ, I hereby release any an all persons or organizations providing or using the information from any and all liability for damages that may result due to compliance or an attempt to comply with this authorization. I waive any right that I may have to inspect any information provided about me by any person or organization identified by me in this application.

I understand that if there are allegations of my having committed improper behavior, I will be required to step down from my responsibilities until such time as the Board of Elders allows me to resume those responsibilities, even if I contend I did not behave improperly.

Should my application be accepted, I agree to abide by the policies of Algonac Church of Christ and to refrain from unscriptural and illegal conduct in the performance of my services on behalf of the church.

I have carefully read and agree to abide by the Child Interaction Policy of Algonac Church of Christ and to protect the health and safety of the youth at all times.

I hereby acknowledge that the information given above is accurate and I give permission to the community for the use of my photographs that are taken by staff/volunteers in order to use for social media.

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