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CALENDAR
WILD KIDS SERVING APPLICATION
First Name
Last Name
Address 1
Address 2
Country
City
State
Zip/Postal Code
Phone Number
Email
Date of Birth
How long have you attended Epic Church?
Less than 3 months
3-6 months
6-12 months
More than a year
Are you a partner of Epic Church?
No
Yes
Would like more info
Which age group do you feel most passionate about serving?
0-18 months
18 months - 3 years
3-5 year olds
K-3rd Grade
4th-5th Grade
Middle/High School
How often would you like to serve?
Once a month
Twice a month
As often as needed
If you are under 18, please list name of parent(s).
Reference #1 Name
Reference #1 Address
Address 2
Country
City
State
Zip/Postal Code
Reference #1 Phone Number
Reference #2 First Name
Last Name
Reference #2 Address 1
Address 2
Country
City
State
Zip/Postal Code
Reference #2 Phone Number
Reference #3 First Name
Last Name
Reference #3 Address 1
Address 2
Country
City
State
Zip/Postal Code
Reference #3 Phone Number
Have you ever abused, or been accused of and/or convicted of, abusing a child or spouse?
Yes
No
Have you ever molested, or been accused of and/or convicted of molestation of a minor?
Yes
No
Do you currently struggle, or have you struggled, with any form of pornography?
Yes
No
Have you been diagnosed with HIV, AIDS, Hepatitis B, or any other communicable disease?
Yes
No
I give epic-a community church the right to further investigate my background and to secure additional information about me, if job related. I hereby release from liability, epic-a community church, its employees and its representatives for seeing such information and all other persons, corporations or organizations for furnishing information. I understand that epic-a community church will run a background check on all applicants who work with children; this form will be kept strictly confidential.
I agree
Submit