Holiday Club 2017 Leader Application Continued

Your Details:


Surname:

First Name:

Birth Date:
 

Emergency Contact number (someone who is not on Holiday Club)

Number (if still at school please put a parent's/guardian's number)
Name and relationship to you (if still at school please put a parent's/guardian's name) 

What are you doing this year?

If you are at school, what grade are you in:
If you are at varsity, what year are you in:
If you are at varsity, what are you studying:
If you are working, what work do you do:

Anything else we should know about you:


Some details to help us with our planning:
Training is provided so experience and qualifications are not necessary. However it would be helpful to have the following information:

Any experience you have had in youth or children's work, either inside or outside of the church:


Any practical experience you have (e.g. art, music, PA systems, sports interests etc):


Any leadership or public speaking experience:


What about you

What are your main reasons for wanting to be involved in Holiday Club 2017:


What is your understanding of being a Christian:


If you have started a relationship with Jesus, we would love to know how and when, and how it has affected your life:


Some health and safety Questions:
Answering "yes" to any of these questions won't necessarily exclude you from joining the team. However, please comment as fully as you feel appropriate:

Do you have any current or spent criminal convictions, cautions or cases pending (other than minor traffic offences):
No
Yes
If yes, please explain:


Do you have medical conditions or allergies (E.g. hay fever, allergy to particular foods):
No
Yes
If yes, please explain:


Are you currently receiving Medical Treatment:
No
Yes
If yes, please explain:


Have you received treatment or counselling for depressive or any other mental illness in the past three years:
No
Yes
If yes, please explain:


Do you require any special dietary requirements (E.g. wheat/gluten intolerant, vegetarian etc):
No
Yes
If yes, please explain


Have you been accused or convicted of sexual or child abuse:
No
Yes
If yes, please explain


Referees
Before accepting you on the team we would encourage you to have two suitable references. Please give the names and details of two people. One should be a church leader and the other another older committed christian. Neither should be family members or peers. If you don't have one or both of these then please just leave that section out.

Reference 1: Church Leader

Full Name:
Cell Number:
Email Address:

Reference 2: Older Christian Friend

Full Name:
Cell Number:
Email Address:

I have read all the sections of this application form and filled it in as honestly as possible:
Yes


Thank you for taking time to fill in this application form. Please click the "send' button below and we will be in touch in the next couple of days.
 


 
 

Christ Church Kenilworth  |  Cnr Summerley & Richmond Road  |  Tel: +27 (021) 797 6332  | E-mail: reception@cck.org.za
Service Times: Sunday Worship  8.00am, 10.00am & 6.30pm  |  Wednesday Service: 10am   | Tuesday Quiet Service: 6.30pm (fortnightly)

Taryn Galloway, 06/05/2015