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  • Please make sure that you have watched the children's worker video and read the abuse prevention policies before starting to fill out this form. You will also need the phone numbers and email addresses of your two references.
  • Housing/Rooming Info:

  • Reference Check

  • Background Check Release Form

  • NOTIFICATION AND RELEASE Maranatha Baptist University & Seminary 745 West Main Street, Watertown, WI 50934 The information contained in this Notification and Release is for use in my role working and/or volunteering with minors at Maranatha Baptist University & Seminary (hereinafter, “Maranatha”) and is true to the best of my knowledge and belief. I understand that any misrepresentation or false statement made by me in connection with this Notification and Release or any related documents which is deemed material by Maranatha shall result in Maranatha declining use of my services or requesting my dismissal from Maranatha-sponsored camps and events. I understand and agree that all information furnished may be verified by Maranatha or its authorized representative. I hereby acknowledge that I have been informed by Maranatha that Maranatha may seek to obtain an investigative report that will include personal information regarding me, including but not limited to, educational history, work references, driving record, drug testing and criminal convictions or arrest records if allowed, in order to assist Maranatha in making certain decisions. I further acknowledge notification by Maranatha that reports may be provided to Maranatha by other firms subcontracted for that purpose. I, my heirs, assigns and legal representatives, hereby release and fully discharge Maranatha, its parent and affiliated companies and the respective officers, directors, shareholders, employees, agents of each, including subcontractors, from any and all claims, monetary or otherwise, that I may have against Maranatha, its parent, affiliates or subcontractors, arising out of the making, or use of, an investigative report, including any errors or omissions contained or omitted from such reports or investigations. Maranatha agrees to inform you if the decline of your services has been influenced by information contained in such reports.
  • Signature
    By signing this form, I agree to fulfill the camp staff requirements if I qualify and am selected for this position.
  • Date Format: MM slash DD slash YYYY