Community Life Serve Form

Full Name

Phone Number

Phone Number - Old

Date of Birth

If you have attended Rooted - When did you last attend Rooted and who was your facilitator?

Describe your Rooted Experience.

What was one life change you experienced as a result of going through Rooted?

If yes, approximately how long have you been attending?

In what ministry roles have you served?

Why do you want to be a Rooted or Home Community Leader?

Please tell us your Jesus story.

Full name of Reference 1

Relationship to Reference 1

How long have you known Reference 1?

Reference 1 Phone Number

Reference 1 email address

Full name of Reference 2

Relationship to Reference 2

How long have you known Reference 2?

Reference 2 Phone Number - Old

Reference 2 Phone Number

Reference 2 email address

What aspect of Community Life are you MOST interested in serving in - Rooted, Home Community, Women's Community or Men's Community?

If you are most interested in serving in Rooted or Home Community, please click here to view the Rooted Leader Commitments.

I confirm I have read and agree to support the Rooted Leader Commitments. I understand that I should consult the Rooted Pastor for clarification and guidance, or if I have any questions that are not answered in the document. I also acknowledge that revisions to the commitments may occur at any time. I recognize that, as a condition to my service, any references may be contacted, a background check will be made and a criminal history check may be conducted, and I willingly consent to all such checks. I further authorize my references to provide any information they may have regarding my character and fitness for working with children. I release Beaverton Christian Church and all such references from any and all liability for any damage that may result from furnishing such evaluations to you, and I waive any right that I have to inspect references provided on my behalf. By checking YES below, I acknowledge that I have received and read the Rooted Leader Commitments Document, that I have carefully read the foregoing release, and know and understand the contents. I also acknowledge that all of the information I have provided is true and complete.

I agree, as a volunteer serving Beaverton Christian Church, and reaching out to those beyond the church, to live an exemplary Christian lifestyle as to encourage other believers and strengthen the church. Further, I agree to respect the privacy of the people Beaverton Christian Church serves, and I agree to hold in confidence any information I obtain in the course of service, whether I obtain that information through written records or daily interaction with an individual. I agree not to disclose an individual’s confidences to anyone, except in the following circumstances: (1) As mandated by law. (2) To prevent a clear and immediate danger to individuals. (3) Where I am compelled to do so by a court or pursuant to the rules of a court. I agree to abide by the church’s policies to store or dispose of records in ways that maintain confidentiality. I agree to uphold confidentiality toward the people the church serves, colleagues, applicants, and any sensitive situations arising within the church.