Leader Information

Name*

First Name Last Name

Birth Date*

Month Day Year

Mobile No.

Gender

Male Female

Email*

example@example.com

Address

Street Address

Street Address Line 2

City State

Postal Code Country

Licence Number

Licence Type

If over 25 and fully licensed, will you be willing to be a Driver for youth group events?

Yes No N/A

If 'Yes' than you will be required to fill in an MCC Leader Driver Form (attainable form the Youth Pastor MCC or Youth Drop box).

Vehicle/Driver Infringements if becoming a Youth Leader Driver

List date and offense

Occupation

FT - Full Time, PT - Part Time

Ministry Activities involved in.

Particular Interest & Skills

Do you have a police record*

Yes No Unsure

If you answered 'Yes" to a police record please detail here.

If additional room needed please email details to: admin@marionccorg.au Please mark 'CONFIDENTIAL - C/O Youth Pastor'

Does you have any allergies, chronic illness, or medical conditions? If yes, please describe.

Are you prescribed an inhaler or Epi Pen? If yes, please explain any instructions.

Or list any other regular medication you may need administered during youth events

Emergency Contact's Name

First Name Last Name

Relationship

Phone Number

Area Code Phone Number

Alt. Phone Number

Area Code Phone Number

Have you submitted a copy of your valid DHS working with children and vulnerable people check (previously National Police check) to admin@marioncc.org.au?*

Yes No

Date of DHS or Police Check Acquired

If you have answered 'No' to this question you are not elgible to commence Youth Leading at Marion Church of Christ unitl you have completed this step.

Have you submitted a copy of your current Child Safe Training certificate to admin@marioncc.org.au?*

Yes No

Date of Child Safe Training Completed

If you have answered 'No' to this question you are not elgible to commence Youth Leading at Marion Church of Christ unitl you have completed this step.

Is there anything else that you need to declare that might effect your capacity or eligibility to act as a leader of youth and young people?

If 'yes' please detail and discuss with the Youth Pastor @ MCC

1. I recognise that every child/young person has the right to be treated with dignity and respect, and to expect trustworthy and responsible leadership.

2. I have read and understood the information in the current youth leadership policy document outlining my role and responsibilities in children's and youth ministry @ Marion Church of Christ (MCC).

3. With God's help, I commit myself to work within the guidelines laid down in the Marion Youth Policy documents.

4. I realise I am in a position to role model to children and youth and I will therefore seek to conduct myself appropriately at all times.

5. As part of my commitment to youth ministry, I agree to give priority to attend leaders meetings and training sessions or requirements that are part of the youth programme I am involved in.

6. I recognise that child abuse is a serious matter and that any suspicions a child is the victim of any form of abuse (physical, sexual, emotional or neglect) should immediately be reported to the Professional Standards Officer (unless the said person is implicated) with a view to reporting the matter to the Child Abuse Report Line. I also understand that if any person in a supervisory or caring role within the Church is suspected of abusing a child, this matter will be reported to the Child Abuse Report Line by the Professional Standard Officer or another person representing leadership at Marion Church of Christ.

7. I understand that a Pastor or a Governing Council member may wish to interview me before placing me in a position of trust, or as a continuing requirement of accountability. I also understand that I have a duty to fully disclose to an appropriate leader anything that might negatively affect my ability to fulfil my responsibility and duty of care in my capacity as a youth leader.

8. I agree to the church taking the following steps if it sees fit:

(a) conducting a DHS check (compulsory); and

(b) seeking references from previous churches, and/or

(c) obtaining references from employers.

I expect that I will be notified and my authorisation will be required if any such information is being sought by Marion Church of Christ Leadership or appointed body. I also understand that all information obtained shall be held by Marion Church of Christ records in the confidence and will be stored according to the current Australian Privacy Act legislation.

(Electronic or physical signature required prior to commencing youth leadership.)

Note:
From time to time leaders will be asked to fulfil various roles as a youth leader and these may include the purchasing of items for supper, to run the night successfully or in participating in training. Costs for being involved in leadership should not be a burden to leadership so a reasonable amount up to the budget allowed for each night will reimbursable for those out of pocket expenses. Please ensure you have discussed this with the youth pastor or financial controller for youth activities prior to purchasing items. Youth leadership training may on occasion be subsidised or fully paid for by Marion Church of Christ at the discretion of the Pastor/s or Governing Council. Marion Church of Christ aim to provide at least one opportunity per financial year for youth leaders to receive some training where possible.
Youth leaders should be prepared to give a testimony talk at some time throughout their time as a youth leader. It is understood that not all people have a gift in or able to, speak to groups so this is not a requirement to youth leadership but is definitely encouraged.

Confirmation

BY ACKNOWLEDGING AND SIGNING 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.

Signature

Clear

Element Youth - Leader Registration 2020

Emergency Contact Information

Leader Requirements

MARION CHURCH OF CHRIST