Your Name (required)
Your Email (required)
Mobile Phone Number (required)
I would like to connect with a Life Group:
Women's Life GroupN/A Men's Life GroupN/A Mixed Life GroupN/A Growing Families Life GroupN/A Impakt Youth (Yrs 5-12)N/A Young Adults (YADs)N/A
I would like to connect with some other events:
The Shed for menN/A Unique WomenN/A MESHN/A Girls' BrigadeN/A PlaytimeN/A Praise DanceN/A
I would like to connect and serve with others:
First Impressions Team
Welcoming TeamN/A Connect Desk TeamN/A
Creative Ministry Teams
Music TeamN/A Sound Desk TeamN/A Media TeamN/A Arts TeamN/A
Hospitality Teams
Kitchen TeamN/A Barista Coffee TeamN/A Food & Hospitality TeamN/A
Cleaning & Service Teams
Sunday Set Up TeamN/A Maintenance TeamN/A Mowing TeamN/A Gardening TeamN/A Cleaning TeamN/A Communion TeamN/A
Teaching Teams
Kids ChurchN/A Impakt YouthN/A Religious InstructionN/A Young AdultsN/A Life Group LeaderN/A
Other:
Digital and Marketing TeamN/A Prayer TeamN/A Pastoral Care TeamN/A Evangelical & Events TeamN/A
Is there anything else we can help you with?
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Beenleigh & District Baptist Church
Please complete if you are providing transport during Youth Group activities. All drivers must have an OPEN Licence and hold a current Blue Card if transporting children or young people. Driver's Name: Your email: Mobile Phone: Emergency Contact Name & Phone Number: Car Registration Number: Driver's Licence Number:
Licence State of issue: QLDNSWVICSAWANTACTTAS
Licence Expiry Date:
Type of licence: CarBusOther
If other, please specify:
Number of years driving experience (minimum 3 years):
Blue Card required? yesno
If yes, Blue Card Number:
Blue Card Expiry Date:
Do you have any restrictions on your licence, e.g., night driving, or a medical condition and/or medications which may affect your ability to drive safely? yesno
If yes, please specify:
Witness to complete:
Licence sighted by:
Email of Witness:
Declaration:
I have completed all screening requirements for the organisation, in relation to my suitability to work with children.
I will drive carefully and follow the road rules when driving on behalf of Beenleigh Baptist Church.
I will provide a registered, roadworthy vehicle.
I will ensure that all passengers wear a seat belt.
I will not drive under the influence of alcohol or drugs or permit smoking in the vehicle.
I will not transport only one child unless he/she is my own child. (Transporting all other children requires a current Blue Card)
I have a good driving record. I have not committed traffic offences in the recent past, which preclude me from transporting participants. If unsure, I will discuss this with my team leader prior to offering myself to drive.
I acknowledge that this information is correct and indicates my commitment to the safety and welfare of those for whom I am responsible. YesNo
WPS-02 January 2022
