VOLUNTEER APPLICATION

Volunteer Application

Volunteers are the heartbeat of our ministry.
Minimum Requirements
- One Form of ID (picture ID)
- Completed Application
- To volunteer with a Disaster or Rebuild deployment, anyone under 16 must be accompanied by a parent or guardian. The parent or guardian must sign a release on the application on behalf of the minor.
- To volunteer with Blessing Bucket projects, volunteers can be age 10 and up, but must be accompanied by a parent or guardian. The parent or guardian must sign a release on the application on behalf of the minor.
God's Pit Crew is honored to have new volunteers who believe in our mission of serving others in their time of need. The safety and well-being of our volunteers take precedence and we appreciate your patience while we process your application for approval. Before becoming an active volunteer, God's Pit Crew, Inc. will conduct a background check and verify work and character reference witnesses. Although having a criminal record may not exclude you from becoming a volunteer, all factors will be considered.

Any applicant with a conviction of a violent crime or a crime of a sexual nature will not be permitted to volunteer at God's Pit Crew.
Contract of Volunteerism

(Note: This is not a contract of employment.) As a volunteer, I understand and am aware of the risk associated therewith and voluntarily assume such risk as a volunteer by participation in and aiding God’s Pit Crew, Inc. in rendering services to their mission both at 2499 North Main Street, Danville, VA 24540 or various locations off-site. If accepted as a member of this team, I agree to release and discharge the organization and individuals which helped make these arrangements, including God’s Pit Crew, their agents, employees, officers and other volunteers from all claims, demands, actions, judgments or executions that I have ever had, or now have, or may have or which my heirs, executors, administrators, or assigns may have or claim to have, against this organization, their agents, employees, officers and other volunteers, and their successors or assigns for all personal injuries, known or unknown and injuries to property, real or personal, caused by, or arising out of this journey.As a volunteer, I agree to represent God’s Pit Crew, Inc. to the highest standard. I realize that I not only represent God’s Pit Crew, Inc. but the Lord Jesus Christ and will conduct myself accordingly. I understand that God’s Pit Crew, Inc. reserves the right to dismiss my volunteerism at any time for any reason.I fully understand that backpacks and/or large bags are not permitted at God’s Pit Crew, Inc. and no items shall be removed from the warehouse without permission and required paperwork completed in its entirety. All bags are subject to search with reasonable suspicion.I have read, understand and agree to the Contract of Volunteerism as well as certify that all information included in my application is true to the best of my knowledge.
Name of Applicant
Name

First NameLast Name
Signature

Clear
Date

MonthDayYear
Date
For applicants under 16, a signature from a parent or guardian is required.
Parent or Guardian Signature
Name

First NameLast Name
Date

MonthDayYear
Date
Signature

Clear

Personal Information
Name

First NameLast Name
Date of Birth

MonthDayYear
Date
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Email*
example@example.com
Official Citizenship
Emergency Contact
Name

First NameLast Name
Relationship
Phone Number
Please enter a valid phone number.

Work/Volunteer History and Education

Please Include both paid and volunteer work experience beginning with most recent
Previous Work/Volunteer Experience
Organization Name
Address
From

MonthDayYear
Date
To

MonthDayYear
Date
Supervisor Name and Title
Previous Work/Volunteer Experience cont.
Organization Name
Address
From

MonthDayYear
Date
To

MonthDayYear
Date
Supervisor Name and Title
Previous Work/Volunteer Experience cont.
Organization Name
Address
From

MonthDayYear
Date
To

MonthDayYear
Date
Supervisor Name and Title
Education
Highest Level of Education Completed
Institution
Are you currently enrolled in school? If so, where?

Medical Information
The work of God's Pit Crew volunteers requires the following physical activities: (ie: sitting, standing, lifting, bending, squatting, kneeling, as well as climbing ladders, scaffolding or trusses.) Would you be able to perform all of these physical activities? If not, which of the listed physical requirements would you not perform and what, if any limits, would you place upon your own activities if involved as a volunteer?
Family Physician:
Phone Number
Please enter a valid phone number.
Do you have medical insurance?
Company Name
Policy Number
Are you allergic to any medicine? If so, explain

	Skills/Interests
Cleaning
Grounds/Maintenance
Sorting/Separating Product
Receptionist
Office Duties
Photography
Archive/Data Entry
Forklift Operator
Wood Working
Vehicle Maintenance
Chainsaw Sharpening
Chainsaw Operation
Wash/Wax Trucks/Equipment
Plumbing
Electrical
Construction
HVAC
Heavy Equipment Operator
Class A CDL Truck Driver
Disaster Response
Other

Disclosure and Authorization - Background Investigation
In connection with my application to serve as a volunteer with God's Pit Crew, Inc. ("Client'), I understand that a "consumer report" and/or "investigative consumer report", as defined by the Fair Credit Reporting Act, will be requested by Client for volunteer purposes, from Protect My Ministry, Inc., ("Protect My Ministry"), a consumer reporting agency as defined by the Fair Credit Reporting Act. These reports may include information as to my character, general reputation, personal characteristics or mode of living, whichever are applicable. They may involve interviews with sources such as my neighbors, friends or associates. The report may also contain information about me relating to my criminal history, credit history, driving and/or motor vehicle records, social security number verification, verification of education or employment history, worker's compensation or other background checks. Such reports may be obtained at any time after receipt of this Disclosure and Authorization and if I am chosen to serve as a volunteer, throughout the course of my volunteer service, as permitted by law and unless revoked by me in writing. Before any adverse action is taken on the application for volunteersim, a copy of the report received by God's Pit Crew, Inc. will be delivered to the applicant. I understand that I have the right, upon written request made within a reasonable amount time after the receipt of this notice, to request disclosure of the nature and scope of any investigative consumer report to Protect My Ministry, Inc., 14499 N. Dale Mabry Hwy., Suite 201 South, Tampa, FL 33618 or 1-800-319-5581. For information about Protect My Ministry's privacy practices, see www.protectmyministry.com.

Confidential information provided by volunteer applicants will be kept in a secured location with limited access by God's Pit Crew staff only.

Acknowledgement and Authorization

By signing below, I voluntarily and knowingly authorize Client or its authorized agents to obtain or prepare consumer reports or investigative consumer reports about me. I acknowledge receipt of a copy of A Summary of Your Rights under the Fair Credit Reporting Act and certify that I have read this Disclosure and Authorization as well as the summary explaining my rights under the Fair Credit Reporting Act.
I wish to receive a copy of any report on me that is requested.
TODAY'S DATE

MonthDayYear
Date
Signature

Clear
Name*

First NameLast Name
Middle Name/Initial
Home Address*

Street Address

City

CountyState / Province

Postal / Zip Code
SSN*
D/L or STATE ID
State Issued
Email*
example@example.com
FULL DOB*

MonthDayYear
Date
Please List All Other Names Used
If Applicant is Under the Age of 18 have Parent or Guardian sign and fill in slots below. This is to authorize God's Pit Crew to run a background check on Applicant.
Name

Parent/Guardian First NameParent/ Guardian Last Name
Date

MonthDayYear
Today's Date
Signature

Clear

MEDIA CONSENT, RELEASE, AND WAIVER

I hereby give consent to God's Pit Crew to photograph, videotape, or otherwise digitally record and
use images and/or sound recordings of myself or my child or children (if applicable) to use in any
public media, including radio, television, internet, social media, print or in any of the organization’s
or its partners’ publications, productions, or posts. I understand that the intended use of such images
and information is solely for the purpose of advertising, marketing, fundraising and/or the promotional
and public awareness purposes for the organization. I hereby waive any rights or interest in the images
or recordings, as contemplated in this release.

I acknowledge that this consent to use images and/or recordings is being made solely for the
benefit of the organization and comes without any expectation of monetary compensation or other
benefit to me. To the extent that any benefit accrues or might accrue to the organization from the
use of images or information, I hereby and forever waive any interest in or claim to such benefits.
I hereby release and forever discharge the organization (including without limitation all corporate
affiliates and officers, directors, trustees, donors, employees, agents and volunteers) from any and
all claims, liability, actions, suits, demands, costs, expenses or indebtedness arising out of, related
to, or in any way connected with the use of images and materials described herein, and I hereby
waive all rights and interest in and to such information and materials.

I further acknowledge that there is no guarantee that any or all of the participants’ images or
recordings will be used in any released media.

Confidential information provided by volunteer applicants will be kept in a secured location with limited access by God's Pit Crew staff only.

I have read, understand and agree to the Contract of Volunteerism as well as certify that all information included in my application is true to the best of my knowledge.
Name

First NameLast Name
Date

MonthDayYear
Date
Signature

Clear
For Applicants under 16, a signature from a parent or guardian is required.
Name

First NameLast Name
Signature

Clear
Date

MonthDayYear
Date

Please provide a picture of a valid photo ID*

Cancelof
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Volunteer Application

Minimum Requirements

Contract of Volunteerism

Name of Applicant

For applicants under 16, a signature from a parent or guardian is required.

Parent or Guardian Signature

Personal Information

Emergency Contact

Work/Volunteer History and Education

Previous Work/Volunteer Experience

Previous Work/Volunteer Experience cont.

Previous Work/Volunteer Experience cont.

Education

Medical Information

Disaster Response

Disclosure and Authorization - Background Investigation

Acknowledgement and Authorization

For Applicants under 16, a signature from a parent or guardian is required.