Adult Volunteer Application Form

Personal Identifying Information

Include Area Code
Include Area Code
What church are you a member of or do you attend at regularly?

Volunteer Information

What youth age groups or programs are you interested in volunteering with?
What special skills/interests do you have that might be relevant to the NWRCC Summer Camp/Winter Retreat programs (i.e. bible study, music, sports, crafts, hiking, etc.)?

Background Check Information


The NWRCC is authorized to conduct criminal background checks on volunteers working with minors.  All persons participating in NWRCC events for youth must agree to the request for Criminal History Information as per the Child/Adult Abuse Information Act, RCW 43.43.830 through 43.43.845.

With your digital signature below you are acknowledging you understand this background check will be done.  A copy of the report will be provided to you at the email address given above.


I desire to serve as a volunteer working with youth for the NWRCC.  I understand that the references I indicate may be contacted to confirm my character and abilities as appropriate for leadership at the events I participate in.  I promise to cooperate with other counselors, directors and staff and to uphold all standards set forth by the Region and the event leadership.  With God’s help, I will seek in every way to provide an experience on the highest Christian level for all who attend the event which I serve.  I will participate in all training opportunities planned for the event and at all times will conduct myself as the Christian example I am called to be.

I understand this application is good for three years from the date this form is submitted and will need to be completed again at its expiration.


Sign to Authorize
Background Check

By checking this box I state that I have read and agree to the authorization information above. Checking this box represents your digital signature and authorization. You cannot receive approval to participate as an Adult Volunteer working with minors in the Northwest Regional Christian Church (Disciples of Christ) ministry programs without this consent and background check.


Two References are necessary for a complete application.

  • One reference must be your pastor. In the case of clergy applying the Regional Minister or a clergy colleague may be substituted. For those congregations without a called pastor the Moderator/Chairperson of the church board or Youth Group Leader may be substitutd. 
  • In addition to one reference from a minister select one person familiar with your character as it relates to working with children or youth.
  • Do not include a relative or significant other; the two references should not be related to one another.

Reference Forms

You can download a paper copy of the Reference Form at:

Your Reference may fill out a form online with a digital signature at: