Personal Identifying Information


Volunteer Information

Background Check Information and Authorizations


The Christian Church (Disciples of Christ) in the Northern Lights Region is authorized to conduct criminal background checks on volunteers working with minors. All persons participating in NLR events for youth or with 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.


I desire to serve as a volunteer working with youth for the Northern Lights Region. I understand that personal references 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 volunteers, 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 and covenant above. You cannot receive approval to participate as an Adult Volunteer working with minors in the Northern Lights Region of the Christian Church (Disciples of Christ) ministry programs without this consent and background check.

Checking a box represents your digital signature.


Two References are necessary for a complete application.

  • One reference must be your pastor. In the case of clergy applying the Regional Minister must be your pastoral reference. For those congregations without a called pastor the Moderator/Chairperson of the church board or Youth Group Leader may be substituted.
  • 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.

Open this page and bookmark the form to share with your selected references. The form link can also be found in the Ministries>> Youth and Children's Ministries menu item of the Northern Lights Region website.