1 Synergy Accredited Leader Application Form 2016 Checklist Evidence of continuing training and development in the ministry to young people. Course attended: Date: Examples may be Me Too!, Children s Ministry Training Package, attendance at a Synergy Day of Encouragement, attaining competencies through the St Mark s Dip in Ministry and Theology. Current Creating Safe Ministry training Course attended: Date: A completed Safe Ministry Check: Lay Church Workers Screening Questionnaire You can download the questionnaire at www.synergy.org.au Verified Working With Children Check (NSW) or Working With Vulnerable People Check Name of applicant DOB Address Contacts Home Work Mobile Email Emergency contact Relationship to you Home or Mobile Leadership information Current church: Name: Length of time: Previous church attended, if you have only been at the above church for less than 6 months
2 Is this is your first time you are applying to be a SAL? If so please write a brief description about your previous leadership experience and responsibility: If you have been a SAL before, please list the years you have been accredited. Drivers License no. What leadership role/s do you expect to perform? e.g. camp director, cabin leader, scripture teacher Parish Recommendation I, the Rector or Minister at have met with and hereby recommend as a SAL. I have verified that they have a Working With Children Check clearance number: Number Exp Date: Rector/Minister s Name Signature Date Medical information Do you have any mobility, medical or dietary needs that we should know about in order to care for you? If yes please give details:
3 Declaration I confirm that the information I have supplied on this form is true and correct to the best of my knowledge. I understand that, should it be found that any answer is untrue, I may have my accreditation revoked. I agree that the Director of Synergy may contact my Rector or Minister mentioned in this application, and any other person whose knowledge of me may assist the Director to determine my suitability for appointment, and that a copy of this application may be sent to any referee listed above. I confirm that I have read, understood and agree with the Camp Pelican Leader s Guide and Expectations document contained at the end of this form. Print name: Signed: Date: Office use only Application Received on: Application Processed by: Endorsements applied for: None: Driver: SRE: Outcome of Application: Application approved Application not approved
4 Application to drive young people Complete this part only if you wish to drive young people Name on licence Date of initial licence Renewal date: Current driver s licence number Type of vehicles licensed to drive (car, truck, bus, etc) Have you lost your licence in the last five years due to any traffic offences? Please give details. Is the vehicle you are driving comprehensively insured? All approved drivers using their own personal car to transport campers to activities, must have an open licence (not on P s) and comprehensive insurance cover. Please attach a photocopy of current drivers licence to this completed Signed: form. Dated:
5 Camp Pelican Leader s Guide and Expectations At Camp Pelican, we aim to make sure that camp is as safe as possible for campers and leaders. To work towards our vision and mission, it is important that we set in place requirements and expectations for all leaders. Our mission supports that of the Diocese of Canberra and Goulburn. Primary Responsibilities To ensure, as far as possible; the safety of the campers assigned to you on camp. To ensure an inclusive culture in conversations, discussions and events on camp. This will include meals, activities and sessions. To be examples of Christ in all things, serving, sharing and communicating the message of Jesus to all people. To attend all leader meetings whilst on camp, unless otherwise excused by the Camp Director. Attend at least 2 team meetings before camp. If attendance is not possible it is the leader s responsibility to be aware of the outcomes of team meetings and the progress of the camp program. Leaders are to refrain from using mobile phones in front of campers or during camp events. Phones may be used in your free time. Leaders are to ensure that they have good sleep and rest before, during and after camp. Unity is a high priority on camp. Please use wisdom when involved in disagreements and when discussing issues with campers and other leaders. We are to be examples of Christ for all campers and leaders. It is strict policy that no leader is to be alone with another camper of the opposite sex whilst on camp. Please refer to CSM manuals for more on conduct with minors. Alcohol or substance abuse is strictly prohibited on camp. Any leader or camper in breach of this regulation will be asked to leave camp at their expense. (Communion wine is permitted for The Lord s Supper and other Communion associated activities) Selection Criteria Each leader is to be involved in or committed to a church community. Each leader is to be a committed Christian that desires a growing relationship with Christ. It is desirable but not essential that leaders be involved in youth or children s work or ministry in some capacity. Each leader is to have a desire to see young people engage with and grow in Christ. Each leader is to be a person of integrity and humility, seeking to have mercy, compassion and justice. Each leader must have completed a Creating Safe Ministries course or equivalent. Each leader must have completed a Working with Vulnerable People (ACT) or Working with Children Check (NSW) (any persons that have been convicted of child abuse in any form cannot be a leader on any given camp).