ADULT VOLUNTEERS for MLK Lock-in and Day of Service, Alameda Deanery
For this event, we require at least one adult overnight chaperone from every sending congregation. 
The event runs from 3 pm Jan. 14th (Sunday) to 3 pm Jan. 15th (Monday)
Please fill out this form to sign up as a volunteer. 
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Email *
Your name *
Phone #
Church affiliation 
Name(s) of youth you're supervising *
What church or youth group do you attend? *
Do you plan to stay overnight at St. Paul's?
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If you can NOT stay overnight, please indicate all parts of the programming that you can support:
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Do you have any allergies or health concerns that would be relevant in case of emergency? If so, please list them here. *
Please list one emergency contact (name and phone #)
 *
Does the Alameda Deanery Youth program / The Diocese of California have permission to use photos of you in our social media and other online accounts? *
RELEASE OF LIABILITY 

In order for you to participate in this event, you must complete, electronically sign, and submit the following statement of consent / liability waiver and medical release. 

I hereby consent to participate by child in the Alameda Deanery Youth MLK Lock-In and Day of Service. 

I certify that I am above the age of 18.

I hereby agree to release the Diocese of California and any and all affiliated organizations, their employees, agents and representatives, including volunteer drivers (collectively “Releases”) from any and all claims, including negligence, which may be asserted by me on behalf of me, arising from or relating to my participation in the event. In the event this release on behalf of myself is held to be invalid or unenforceable, I hereby agree to indemnify and hold harmless Releases from any and all claims, including negligence, which may be asserted by my self, on behalf of my self, arising from or relating to my participation in the event. This release or indemnification does not apply to claims for intentional misconduct or gross negligence; nor does this release or indemnification apply to the extent of commercial insurance coverage for any claim, but this Release or Indemnification shall apply to the extent of any self-insurance or deductible applicable to any claim.
 
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Please type your full name as an electronic signature, acknowledging your consent of the release above. 
COMMUNITY AGREEMENT

Diocesan Youth Events seek to be safe spaces for youth to live as their authentic selves. To that end we establish a community agreement that youth must agree to adhere to while at Diocesan Youth Events. Adult Leaders agree to the following as well.

I agree:

1. NOT to leave designated program spaces without informing ministry leaders;
2. NOT to bring or use alcohol or any illegal drugs or intentionally misuse any legal drugs;
3. NOT to participate in any violent behavior, including the possession of weapons;
4. NOT to participate in any sexual behavior;
5. TO respect the needs and property of other participants and staff;
6. TO participate in community activities, including chores.

I understand these agreements are designed to provide a safe and supportive community at all events I also understand that if I break one of these agreements,
I will have broken the trust of the community, and may be asked to leave.
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Please type your full name, acknowledging that you have read the community agreement. 
SAFE CHURCH
Per the polices of the Diocese and The Episcopal Church nationally, we require all adult volunteers to complete SAFE Church training and undergo a background check. 

Have you completed SAFE Church training (online or in person) in the last 3 years?
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Have you completed a background check through the Diocese of California in the last 5 years?
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Other comments, questions, concerns:
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