Adult VBS Volunteer

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

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

Street Address REQUIRED Please fill out this field. 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.

Cell Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Email REQUIRED Please fill out this field. Please enter an email address.

Do you have children in VBS? Yes No

If yes, please put names and grades - please fill out a separate registration form for children

Do you have teen helpers in VBS? Yes No

If yes, please fill out a separate registration form for teens.

T-Shirt Size: Adult REQUIRED Small Medium Large XL XXL Please fill out this field.

Adult Emergency Contact and Medical Form

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

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

Cell Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Relationship REQUIRED Please fill out this field. Please enter valid data.

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

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

Cell Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Relationship REQUIRED Please fill out this field. Please enter valid data.

Please enter Medical Insurer, Policy #, Group #Medical Conditions, Allergies, Drug Allergies, and any current medications we should be aware of in a medical situation.

Medical Insurer, Policy, and Group # REQUIRED Please fill out this field.

Please enter any medical conditions, allergies, or drug allergies below including current medications we should be aware of during VBS. REQUIRED Please fill out this field.

WAIVER/AUTHORIZATION FOR EMERGENCY MEDICAL ATTENTION
I, who by law may do so, authorize the administration of emergency medical treatment for the subject of this release form. I understand that all reasonable safety precautions will be taken during this event. I will not hold St. Mark the Evangelist Catholic Church, members of the staff or volunteers responsible for accidental harm or injury that may occur during this event. I understand that, in the event emergency medical intervention is needed, every attempt will be made to contact the person(s) listed on this form immediately. By signing below, I agree to this waiver/authorization.

Please enter full name below as your signature to agree to the waiver/authorization above. REQUIRED Please fill out this field. Please enter valid data.

St. Mark Safe Environment Requirements

All adult volunteers (18 years and older) must have completed a Safe Environment Screening and Training program. In order to volunteer you must meet the following criteria:

Background Screening Information on file at St. Mark. (If you are from another parish, contact parish and give permission for your screening information to be shared with St. Mark. Attention: Linda Sartor, c/o St. Mark.)
Annual Training program. (If you are from another parish, contact parish and give permission for your Training information to be shared with St. Mark. Attention: Linda Sartor, c/o St. Mark.)
Complete Background Screening if this has never been done. Go to St. Mark website “Safe Environment”, www.stmarkplano.org.
Interview with St. Mark Staff after completing screening packet.
Complete Initial Training – contact Linda Sartor at 972-423-5600, ext. 226 or [email protected]

**If you are a returning volunteer – your only requirement is to update Annual Training.

I realize all the above positions require a five-day commitment the week of VBS. I will also attend training meeting on Tuesday, June 30, if this is my first time participating in VBS.

I UNDERSTAND THAT I MUST BE SAFE ENVIRONMENT SCREENED/TRAINED TO PARTICIPATE.

I Agree Please select this field.

Please enter full name below as your signature. REQUIRED Please fill out this field. Please enter valid data.