Prison Campus Volunteer

We are working with God Behind Bars, an organization who has a history of partnering with the local church and building relationships within the prison system to facilitate prisoners’ re-entry into their communities and reunification with their families.

Name *

First

Last

Gender *

Date of Birth *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Email *

Phone *

Driver's License Number *

State Issued In *

Are you a member of Fellowship Church? *

Have you ever been incarcerated? *

Have you ever served time in any adult correctional facility? *

Have you ever worked in prison ministry before? *

By entering my name below, I hereby agree that all the information that I stated is true and correct to the best of my knowledge. I agree as a volunteer that I will not abuse my time inside the prisons and will use it to carry out the God Behind Bars, Inc. transformational strategy. I hereby fully understand that if I do abuse my time inside the prison, I may be subject to lose my access and volunteer rights inside the prison. I hereby fully understand that God Behind Bars, Inc. or any employee of God Behind Bars, Inc. is not responsible if anything may happen personally to me or my belongings that I choose to bring into the prison. I fully understand all the rules of the prison and know it is my responsibility to follow these rules to the fullest extent. I hereby give my permission to God Behind Bars, Inc. and any prison to run a full background check on me. I also fully understand that God Behind Bars, Inc. or any prison can reject or remove my clearance as a volunteer for any reason. *

I AGREE TO THE ABOVE STATEMENT.

By entering my name below, I further acknowledge that the area that I am applying to volunteer has inherent risks and dangers. I agree to comply with the policies and procedures including anti-drug and anti-alcohol usage, dress code, confidentiality policy or other policies in force. In consideration of this application and permitting me to volunteer, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows: (A) Waive, Release and Discharge from any and all liability for my death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter accrue to me, God Behind Bars, Inc., its directors, officers, employees, volunteers, representatives, and agents; (B) Indemnify and Hold Harmless the entities or persons mentioned in this paragraph from any and all liabilities or claims made as a result of participation in volunteer activities, whether caused by the negligence of the persons or entities being released or otherwise. I understand that at this event or related activities, I may be photographed or video-taped. I agree to allow my photo, video, or film likeness to be used for any legitimate purpose by the God Behind Bars, Inc. and/or assigns without compensation to me. *

I AGREE TO THE ABOVE STATEMENT.

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