OneDay FunDay Volunteer Application OneDay FunDay Volunteer Application ALL VOLUNTEERS MUST BE 18 OR OLDER.All information is held strictly confidential. This form must be completely filled out. The information is vital to your acceptance and possible placement as a volunteer. After receiving your information, someone from Mission Georgia will follow up with you to confirm about serving as a OneDay FunDay Volunteer. Registration is required to attend the event. Deadline to register is August 7. Limited capacity - register early! ONEDAY FUNDAY EVENTS Which location(s) will you attend? * Clayton – August 14 Statesboro - August 14 APPLICANT INFORMATION First and Last Name * Email * Mailing Address * Mailing Address Mailing Address Mailing Address City City State/Province State/Province Zip/Postal Zip/Postal Country Afghanistan Aland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bonaire, Sint Eustatius and Saba Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Bulgaria Burkina Faso Burundi Côte d'Ivoire Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Croatia Cuba Curacao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Holy See Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea Northern Mariana Islands Norway Oman Pakistan Palau Palestine Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russia Rwanda Saint Barthelemy Saint Helena, Ascension and Tristan da Cunha Saint Kitts and Nevis Saint Lucia Saint Martin (French part) Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Sint Maarten (Dutch part) Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands South Korea South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam Virgin Islands, British Virgin Islands, U.S. Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Country Cell Phone * Emergency Contact * Emergency Contact Relationship * Emergency Contact Cell Phone * Church Membership * Church City * Provide the name of a church staff member who can confirm your membership. * T-Shirt Size * Adult Small Adult Medium Adult Large Adult XL Adult 2XL Adult 3XL Adult 4XL Select the following areas in which you are certified. CPR First Aid Life Guard Nurse EMT BACKGROUND Have you ever been arrested for a criminal offense? * No Yes Have you ever been convicted of or pled guilty to a crime? * No Yes Have you ever been arrested for sexual misconduct? * No Yes Have you ever been convicted of or pled guilty to sexual misconduct? * No Yes If you answered YES to any of the above, please explain. * Applicant's Statement The information contained in this application is correct to the best of my knowledge. I authorize any references or churches listed in this application to give you any information (including opinions) that they may have regarding my character and fitness for children or youth work. In consideration of the receipt and evaluation of this application to be a OneDay FunDay volunteer, I hereby release any individual, church, youth organization, charity, employer reference, or any other person or organization, including record custodians, both collectively and individually from any and all liability for damages of whatever kind or nature which may at any time result to me, my heirs, or family, on account of compliance or any attempts to comply, with this authorization. I waive any right that I may have to inspect any information provided about me by any person or organization identified by me in this application. I also understand that I am consenting to my personal image being used in media such as still pictures and videos for the possible use of future social media, online, training, or reporting related to Mission Georgia, OneDay FunDay, the Georgia Baptist Mission Board and partnering organizations. I further state that I have carefully read the foregoing release and know the contents thereof and I sign this release as my own free act. This is a legally binding agreement which I have read and understand. Applicant Verification * Yes I agree that providing the requested information and checking this box is the same as having signed my name. Applicant First and Last Name * Date * Upon submission, someone from Mission Georgia will follow up with you to confirm about serving as a OneDay FunDay Volunteer. Submit Δ
