Primary campus *
Select… Fair Haven Harbor Life Jamestown Harbor South Harbor Walker Harbor Wyoming Harbor
Select your Age Group *
ADULTS: Note: After completing this form, you will receive an email from our third-party, trusted background-check partner, Checkr.com, in order to complete a secure background-check. Any questions regarding this process, simply contact us at hcinfo@harborchurches.org.
Select… Adult: Currently 18 Years or Older Student: Currently 17 Years or Younger
Gender *
Select… Male Female
Phone number *
Phone type Mobile Home Work Other
T-Shirt Size
Select… Youth Small Youth Medium Youth Large Small Medium Large X Large 2X Large 3X Large
Preferred Service Time(s) *
Excluding traffic related offenses, have you ever been accused or convicted of criminal activity, or entered a plea of guilty or no contest to a criminal offense of any kind? *
Select… NO YES
Have you ever been accused or convicted of sexual misconduct, or entered a plea of guilty or no contest to abuse or sexual misconduct? *
Select… NO YES
Are you aware of any traits or tendencies that you possess that could pose a threat to children or youth? *
Select… NO YES
I recognize that Harbor Churches is relying on the accuracy of the information I provide on this application. I attest and affirm that the information I have provided is absolutely true and correct. *
Please Initial
I authorize Harbor Churches to contact any person or entity listed on application, and I further authorize any such person or entity to provide the organization with information, opinions, and impressions relating to my background or qualifications. *
Please Initial
I acknowledge and accept the risk of physical injury that could occur from my participation as a volunteer. *
Except for gross negligence on the part of Harbor Churches, I accept personal financial responsibility for any bodily or personal injury sustained while I am volunteering. Further, I release and agree to indemnify and hold harmless Harbor Churches, and its officers, directors, and representatives from any liability, injury, damage, loss, accidents, delay, or irregularity related to being a volunteer for Harbor Churches.
I grant to Harbor Churches the right to make photo, video, and audio recordings of me. *
("Recordings") as well as the perpetual, world-wide right to record, re-record, copy, edit, reproduce, publicly display, perform, and distribute the Recordings in any way consistent with Harbor Churches' ministry, including use on the Internet. I waive the right to inspect or approve the finished product wherein the Recordings appear.
Please note the following release does not apply to any personal, professional, or other project/work that is unrelated to Harbor Churches. *
Any work that I have created in my role/capacity as a volunteer for Harbor Churches in the past, present, or future, recorded in any form ("Creative Work") is for the exclusive ownership of Harbor Churches and is considered a "work made for hire" (defined in the US Copyright Act). If, for any reason, the work related to my volunteer service for Harbor Churches is determined at any time not to be a "work made for hire," I agree to assign, and do assign, to Harbor Churches all right, title, and interest to the Creative Work.
Additionally, I agree to all statements above and certify that I have properly initialed each statement and/or accept that any text placed in the fields provided will be considered acceptance of the statements.
Submit
