Volunteer Application For Rock The Summer Lock-In 2023
This is the volunteer form for the 2023 Rock The Summer Youth Lock-In 

We appreciate your interest in investing in our next generation.

This event is held at Church of the Heartland - Winamac from Friday night July 21 at 8 pm ET through Saturday, July 22 at 8 am ET

Safety and fun are our top priorities.  

If you have any questions at all, feel free to contact:

- Misti Hiatt at 574-249-0606 / mistihiatt@gmail.com
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Email *
Name *
First, Middle, Last
Home Address *
 Include City, State, Zip
Phone Number
Date of Birth *
Place of Birth *
 Include City and State
Other Names (ex. Maiden Name)
Gender *
Are you interested in (check all that apply) *
Required
Hours Available During the Lock In (check all that apply) *
Required
Church that you attend
Three Character References: List pastor, leaders, others who are not related to you that will vouch for your Christian character
Include Name, Address, Phone, Email, Relationship and Years Known
If you have younger/older children than are allowed and do you agree that you will find alternative child care off-site. *
Have you ever been convicted of a crime other than a minor traffic violation? *
Required
If yes, please explain offense and final disposition
PLEASE READ CAREFULLY and check each box, stating that you agree with each requirement *
Required
If you are accepted for one of these volunteer positions, you will be notified by a leader.  Do NOT assume that your application has been accepted, if you have not been contacted.  If there is any confusion as to the status of your application, please contact Misti Hiatt at 574-249-0606  *
Required
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