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Employment Application & Waiver

MUST COMPLETE THE WAIVER AND RELEASE FORM 

PARENT/LEGAL GUARDIAN SIGNATURE IS REQUIRED IF EMPLOYEE IS UNDER AGE 18 

Soaring Chicken Farm Ministry

1302 Felipe

San Clemente, CA 92673

christina@soaringchickenfarms.com

www.soaringchickenfarmministry.com

WAIVER AND RELEASE FORM

RELEASE OF LIABILITY

In return for being allowed to participate in Soaring Chicken Farm Ministry EMPLOYEE activities and all related activities, including any activities incidental to such participation (“Employee Activities”), the under-signed Employee or Parent/Legal Guardian of Employee if Employee is under age 18 (hereafter re-ferred to using “I”, “me”, or “my”) releases and agrees not to sue the Soaring Chicken Farm Ministry or its officers, directors, employees, sub-contractors, sponsors, agents and affiliates (“the Foundation”) from all present and future claims that may be made by me, my family, estate, heirs, or assigns for property dam-age, personal injury, or wrongful death arising as a result of my participation in the Employee Activities wherever, whenever, or however the same may occur.

I understand and agree that the Soaring Chicken Farm Ministry is not responsible for any injury or property damage arising out of the Employee Activities, even if caused by their ordinary negligence or otherwise.  

I understand that participation in the Employee Activities involves certain risks, including, but not limited to, serious injury and death. I am voluntarily participating in the Employee Activities with knowledge of the danger involved and I agree to accept all risks of participation.  

I also agree to indemnify and hold harmless the Foundation for all claims arising out of my participation in the Employee Activities.  

I understand that this document is intended to be as broad and inclusive as permitted by the laws of the state in which the Employee Activities take place and agree that if any portion of this Agreement is invalid, the remainder will continue in full legal force and effect. 

I also acknowledge that Soaring Chicken Farm Ministry has not arranged and do not carry any insurance of any kind for my benefit or that of Employee (if Employee is under 18), my parents, guardians, trustees, heirs, execu-tors, administrators, successors and assigns. I represent that, to my knowledge, I am in good health and suffer no physical impairment that would or should prevent my participation in Employee Activities. 

I also understand that this document is a contract which grants certain rights to and eliminates the liability of Soaring Chicken Farm Ministry .  

PUBLICITY RELEASE

In return for being allowed to participate in Soaring Chicken Farm Ministry employee activities and all related activities, including any activities incidental to such participation (“Employee Activities”), the undersigned Employee or Parent/Legal Guardian of Employee if Employee is under age 18 (hereafter referred to using “I”, “me”, or “my”) hereby grants to Soaring Chicken Farm Ministry , and each of its subsidiaries, affiliates, agents, advertising or promotional agencies, and partners, and all such entities’ officers, directors, agents, employees, respective successors and assigns (collectively, “Authorized Parties”), the absolute and irrevocable right and permission to use, publish, broadcast and/or copyright the use of Employee’s name, address, voice, photograph and/or like-ness, caricature, and personal information, in its current form or as retouched, digitized, cropped, altered, distorted or modified in any way, in any and all advertising, promotional, or other mate-rials based upon or derived from the Employee Activities in any manner, in any media whatso-ever for any and all purposes, including by way of example but without limitation advertising, promoting or publicizing products and services throughout the universe, in perpetuity, in any and all media now known or hereafter devised (including without limitation on the Internet), without additional compensation. I further agree that anything derived there from will be owned solely by the Authorized Parties. I shall not authorize the use of any print, negative or other copy thereof by anyone other than the Authorized Parties. 

I understand that this document is intended to be as broad and inclusive as permitted by the laws of the state in which the Employee Activities take place and agree that if any portion of this Agreement is invalid, the remainder will continue in full legal force and effect.  


Today's Date: November 21, 2024

First Employee's Name

First Name*

Middle Name

Last Name*

Phone*
First Employee's Date of Birth*
First Employee's Information

Schedule

Please complete the following section to the best of your knowledge. We understand that schedules change. Please simply indicate when and how you would like to make yourself available.

I would like to serve on a regular basis. *
Weekly
Bi-monthly
Monthly

Please check the days of the week you would like to work. If you are able, include the approximate time you would be able to arrive and depart on the days you have listed. Ex: (9-5:30)

Monday

Start am/pm

Finish am/pm
Tuesday

Start am/pm

Finish am/pm
Wednesday

Start am/pm

Finish am/pm
Thursday

Start am/pm

Finish am/pm
Friday

Start am/pm

Finish am/pm
Saturday

Start am/pm

Finish am/pm

Please also indicate the following:  


My offer to work expires:

*List the date you wish to no longer be contacted about working or write “no expiration”

Specific Areas of Interest:  

Please check all that apply.
Mentoring/working with children (requires fingerprinting)
Garden/Landscaping
Building/Construction Projects
Herd help (poop scooping, grooming, cleaning water troughs, etc)
Office/Administration
Professional Assistance
Fundraising
Anything and everything

We are open to your ideas. Please list and explain here:

Skills  


* Please list your strengths here

* Of the Skills you possess, which would you like to offer the farm?

Other Questions  


* How did you hear about us?

* Why would you like to work at Soaring Chicken Farm Ministry?

* What message would you like to convey, while working, to children and families at the farm?

* Tell us about yourself, if you’d like…. Interesting facts, outstanding talents, funny stories, favorite foods, hobbies, certifications, awards, achievements, etc.

This is for employees who want to work directly with children. 

Soaring Chicken Farm Ministry is a faith based ministry. We hope to have our leaders that work directly with our clients align with our beliefs.


Please let us know your relationship with Jesus: (summary of your testimony)
First Employee's Signature*
Second Employee's Name

First Name*

Middle Name

Last Name*
Second Employee's Date of Birth*
Second Employee's Information

Schedule

Please complete the following section to the best of your knowledge. We understand that schedules change. Please simply indicate when and how you would like to make yourself available.

I would like to serve on a regular basis. *
Weekly
Bi-monthly
Monthly

Please check the days of the week you would like to work. If you are able, include the approximate time you would be able to arrive and depart on the days you have listed. Ex: (9-5:30)

Monday

Start am/pm

Finish am/pm
Tuesday

Start am/pm

Finish am/pm
Wednesday

Start am/pm

Finish am/pm
Thursday

Start am/pm

Finish am/pm
Friday

Start am/pm

Finish am/pm
Saturday

Start am/pm

Finish am/pm

Please also indicate the following:  


My offer to work expires:

*List the date you wish to no longer be contacted about working or write “no expiration”

Specific Areas of Interest:  

Please check all that apply.
Mentoring/working with children (requires fingerprinting)
Garden/Landscaping
Building/Construction Projects
Herd help (poop scooping, grooming, cleaning water troughs, etc)
Office/Administration
Professional Assistance
Fundraising
Anything and everything

We are open to your ideas. Please list and explain here:

Skills  


* Please list your strengths here

* Of the Skills you possess, which would you like to offer the farm?

Other Questions  


* How did you hear about us?

* Why would you like to work at Soaring Chicken Farm Ministry?

* What message would you like to convey, while working, to children and families at the farm?

* Tell us about yourself, if you’d like…. Interesting facts, outstanding talents, funny stories, favorite foods, hobbies, certifications, awards, achievements, etc.

This is for employees who want to work directly with children. 

Soaring Chicken Farm Ministry is a faith based ministry. We hope to have our leaders that work directly with our clients align with our beliefs.


Please let us know your relationship with Jesus: (summary of your testimony)
Third Employee's Name

First Name*

Middle Name

Last Name*
Third Employee's Date of Birth*
Third Employee's Information

Schedule

Please complete the following section to the best of your knowledge. We understand that schedules change. Please simply indicate when and how you would like to make yourself available.

I would like to serve on a regular basis. *
Weekly
Bi-monthly
Monthly

Please check the days of the week you would like to work. If you are able, include the approximate time you would be able to arrive and depart on the days you have listed. Ex: (9-5:30)

Monday

Start am/pm

Finish am/pm
Tuesday

Start am/pm

Finish am/pm
Wednesday

Start am/pm

Finish am/pm
Thursday

Start am/pm

Finish am/pm
Friday

Start am/pm

Finish am/pm
Saturday

Start am/pm

Finish am/pm

Please also indicate the following:  


My offer to work expires:

*List the date you wish to no longer be contacted about working or write “no expiration”

Specific Areas of Interest:  

Please check all that apply.
Mentoring/working with children (requires fingerprinting)
Garden/Landscaping
Building/Construction Projects
Herd help (poop scooping, grooming, cleaning water troughs, etc)
Office/Administration
Professional Assistance
Fundraising
Anything and everything

We are open to your ideas. Please list and explain here:

Skills  


* Please list your strengths here

* Of the Skills you possess, which would you like to offer the farm?

Other Questions  


* How did you hear about us?

* Why would you like to work at Soaring Chicken Farm Ministry?

* What message would you like to convey, while working, to children and families at the farm?

* Tell us about yourself, if you’d like…. Interesting facts, outstanding talents, funny stories, favorite foods, hobbies, certifications, awards, achievements, etc.

This is for employees who want to work directly with children. 

Soaring Chicken Farm Ministry is a faith based ministry. We hope to have our leaders that work directly with our clients align with our beliefs.


Please let us know your relationship with Jesus: (summary of your testimony)
Fourth Employee's Name

First Name*

Middle Name

Last Name*
Fourth Employee's Date of Birth*
Fourth Employee's Information

Schedule

Please complete the following section to the best of your knowledge. We understand that schedules change. Please simply indicate when and how you would like to make yourself available.

I would like to serve on a regular basis. *
Weekly
Bi-monthly
Monthly

Please check the days of the week you would like to work. If you are able, include the approximate time you would be able to arrive and depart on the days you have listed. Ex: (9-5:30)

Monday

Start am/pm

Finish am/pm
Tuesday

Start am/pm

Finish am/pm
Wednesday

Start am/pm

Finish am/pm
Thursday

Start am/pm

Finish am/pm
Friday

Start am/pm

Finish am/pm
Saturday

Start am/pm

Finish am/pm

Please also indicate the following:  


My offer to work expires:

*List the date you wish to no longer be contacted about working or write “no expiration”

Specific Areas of Interest:  

Please check all that apply.
Mentoring/working with children (requires fingerprinting)
Garden/Landscaping
Building/Construction Projects
Herd help (poop scooping, grooming, cleaning water troughs, etc)
Office/Administration
Professional Assistance
Fundraising
Anything and everything

We are open to your ideas. Please list and explain here:

Skills  


* Please list your strengths here

* Of the Skills you possess, which would you like to offer the farm?

Other Questions  


* How did you hear about us?

* Why would you like to work at Soaring Chicken Farm Ministry?

* What message would you like to convey, while working, to children and families at the farm?

* Tell us about yourself, if you’d like…. Interesting facts, outstanding talents, funny stories, favorite foods, hobbies, certifications, awards, achievements, etc.

This is for employees who want to work directly with children. 

Soaring Chicken Farm Ministry is a faith based ministry. We hope to have our leaders that work directly with our clients align with our beliefs.


Please let us know your relationship with Jesus: (summary of your testimony)
Fifth Employee's Name

First Name*

Middle Name

Last Name*
Fifth Employee's Date of Birth*
Fifth Employee's Information

Schedule

Please complete the following section to the best of your knowledge. We understand that schedules change. Please simply indicate when and how you would like to make yourself available.

I would like to serve on a regular basis. *
Weekly
Bi-monthly
Monthly

Please check the days of the week you would like to work. If you are able, include the approximate time you would be able to arrive and depart on the days you have listed. Ex: (9-5:30)

Monday

Start am/pm

Finish am/pm
Tuesday

Start am/pm

Finish am/pm
Wednesday

Start am/pm

Finish am/pm
Thursday

Start am/pm

Finish am/pm
Friday

Start am/pm

Finish am/pm
Saturday

Start am/pm

Finish am/pm

Please also indicate the following:  


My offer to work expires:

*List the date you wish to no longer be contacted about working or write “no expiration”

Specific Areas of Interest:  

Please check all that apply.
Mentoring/working with children (requires fingerprinting)
Garden/Landscaping
Building/Construction Projects
Herd help (poop scooping, grooming, cleaning water troughs, etc)
Office/Administration
Professional Assistance
Fundraising
Anything and everything

We are open to your ideas. Please list and explain here:

Skills  


* Please list your strengths here

* Of the Skills you possess, which would you like to offer the farm?

Other Questions  


* How did you hear about us?

* Why would you like to work at Soaring Chicken Farm Ministry?

* What message would you like to convey, while working, to children and families at the farm?

* Tell us about yourself, if you’d like…. Interesting facts, outstanding talents, funny stories, favorite foods, hobbies, certifications, awards, achievements, etc.

This is for employees who want to work directly with children. 

Soaring Chicken Farm Ministry is a faith based ministry. We hope to have our leaders that work directly with our clients align with our beliefs.


Please let us know your relationship with Jesus: (summary of your testimony)
Sixth Employee's Name

First Name*

Middle Name

Last Name*
Sixth Employee's Date of Birth*
Sixth Employee's Information

Schedule

Please complete the following section to the best of your knowledge. We understand that schedules change. Please simply indicate when and how you would like to make yourself available.

I would like to serve on a regular basis. *
Weekly
Bi-monthly
Monthly

Please check the days of the week you would like to work. If you are able, include the approximate time you would be able to arrive and depart on the days you have listed. Ex: (9-5:30)

Monday

Start am/pm

Finish am/pm
Tuesday

Start am/pm

Finish am/pm
Wednesday

Start am/pm

Finish am/pm
Thursday

Start am/pm

Finish am/pm
Friday

Start am/pm

Finish am/pm
Saturday

Start am/pm

Finish am/pm

Please also indicate the following:  


My offer to work expires:

*List the date you wish to no longer be contacted about working or write “no expiration”

Specific Areas of Interest:  

Please check all that apply.
Mentoring/working with children (requires fingerprinting)
Garden/Landscaping
Building/Construction Projects
Herd help (poop scooping, grooming, cleaning water troughs, etc)
Office/Administration
Professional Assistance
Fundraising
Anything and everything

We are open to your ideas. Please list and explain here:

Skills  


* Please list your strengths here

* Of the Skills you possess, which would you like to offer the farm?

Other Questions  


* How did you hear about us?

* Why would you like to work at Soaring Chicken Farm Ministry?

* What message would you like to convey, while working, to children and families at the farm?

* Tell us about yourself, if you’d like…. Interesting facts, outstanding talents, funny stories, favorite foods, hobbies, certifications, awards, achievements, etc.

This is for employees who want to work directly with children. 

Soaring Chicken Farm Ministry is a faith based ministry. We hope to have our leaders that work directly with our clients align with our beliefs.


Please let us know your relationship with Jesus: (summary of your testimony)
Seventh Employee's Name

First Name*

Middle Name

Last Name*
Seventh Employee's Date of Birth*
Seventh Employee's Information

Schedule

Please complete the following section to the best of your knowledge. We understand that schedules change. Please simply indicate when and how you would like to make yourself available.

I would like to serve on a regular basis. *
Weekly
Bi-monthly
Monthly

Please check the days of the week you would like to work. If you are able, include the approximate time you would be able to arrive and depart on the days you have listed. Ex: (9-5:30)

Monday

Start am/pm

Finish am/pm
Tuesday

Start am/pm

Finish am/pm
Wednesday

Start am/pm

Finish am/pm
Thursday

Start am/pm

Finish am/pm
Friday

Start am/pm

Finish am/pm
Saturday

Start am/pm

Finish am/pm

Please also indicate the following:  


My offer to work expires:

*List the date you wish to no longer be contacted about working or write “no expiration”

Specific Areas of Interest:  

Please check all that apply.
Mentoring/working with children (requires fingerprinting)
Garden/Landscaping
Building/Construction Projects
Herd help (poop scooping, grooming, cleaning water troughs, etc)
Office/Administration
Professional Assistance
Fundraising
Anything and everything

We are open to your ideas. Please list and explain here:

Skills  


* Please list your strengths here

* Of the Skills you possess, which would you like to offer the farm?

Other Questions  


* How did you hear about us?

* Why would you like to work at Soaring Chicken Farm Ministry?

* What message would you like to convey, while working, to children and families at the farm?

* Tell us about yourself, if you’d like…. Interesting facts, outstanding talents, funny stories, favorite foods, hobbies, certifications, awards, achievements, etc.

This is for employees who want to work directly with children. 

Soaring Chicken Farm Ministry is a faith based ministry. We hope to have our leaders that work directly with our clients align with our beliefs.


Please let us know your relationship with Jesus: (summary of your testimony)
Eighth Employee's Name

First Name*

Middle Name

Last Name*
Eighth Employee's Date of Birth*
Eighth Employee's Information

Schedule

Please complete the following section to the best of your knowledge. We understand that schedules change. Please simply indicate when and how you would like to make yourself available.

I would like to serve on a regular basis. *
Weekly
Bi-monthly
Monthly

Please check the days of the week you would like to work. If you are able, include the approximate time you would be able to arrive and depart on the days you have listed. Ex: (9-5:30)

Monday

Start am/pm

Finish am/pm
Tuesday

Start am/pm

Finish am/pm
Wednesday

Start am/pm

Finish am/pm
Thursday

Start am/pm

Finish am/pm
Friday

Start am/pm

Finish am/pm
Saturday

Start am/pm

Finish am/pm

Please also indicate the following:  


My offer to work expires:

*List the date you wish to no longer be contacted about working or write “no expiration”

Specific Areas of Interest:  

Please check all that apply.
Mentoring/working with children (requires fingerprinting)
Garden/Landscaping
Building/Construction Projects
Herd help (poop scooping, grooming, cleaning water troughs, etc)
Office/Administration
Professional Assistance
Fundraising
Anything and everything

We are open to your ideas. Please list and explain here:

Skills  


* Please list your strengths here

* Of the Skills you possess, which would you like to offer the farm?

Other Questions  


* How did you hear about us?

* Why would you like to work at Soaring Chicken Farm Ministry?

* What message would you like to convey, while working, to children and families at the farm?

* Tell us about yourself, if you’d like…. Interesting facts, outstanding talents, funny stories, favorite foods, hobbies, certifications, awards, achievements, etc.

This is for employees who want to work directly with children. 

Soaring Chicken Farm Ministry is a faith based ministry. We hope to have our leaders that work directly with our clients align with our beliefs.


Please let us know your relationship with Jesus: (summary of your testimony)
Ninth Employee's Name

First Name*

Middle Name

Last Name*
Ninth Employee's Date of Birth*
Ninth Employee's Information

Schedule

Please complete the following section to the best of your knowledge. We understand that schedules change. Please simply indicate when and how you would like to make yourself available.

I would like to serve on a regular basis. *
Weekly
Bi-monthly
Monthly

Please check the days of the week you would like to work. If you are able, include the approximate time you would be able to arrive and depart on the days you have listed. Ex: (9-5:30)

Monday

Start am/pm

Finish am/pm
Tuesday

Start am/pm

Finish am/pm
Wednesday

Start am/pm

Finish am/pm
Thursday

Start am/pm

Finish am/pm
Friday

Start am/pm

Finish am/pm
Saturday

Start am/pm

Finish am/pm

Please also indicate the following:  


My offer to work expires:

*List the date you wish to no longer be contacted about working or write “no expiration”

Specific Areas of Interest:  

Please check all that apply.
Mentoring/working with children (requires fingerprinting)
Garden/Landscaping
Building/Construction Projects
Herd help (poop scooping, grooming, cleaning water troughs, etc)
Office/Administration
Professional Assistance
Fundraising
Anything and everything

We are open to your ideas. Please list and explain here:

Skills  


* Please list your strengths here

* Of the Skills you possess, which would you like to offer the farm?

Other Questions  


* How did you hear about us?

* Why would you like to work at Soaring Chicken Farm Ministry?

* What message would you like to convey, while working, to children and families at the farm?

* Tell us about yourself, if you’d like…. Interesting facts, outstanding talents, funny stories, favorite foods, hobbies, certifications, awards, achievements, etc.

This is for employees who want to work directly with children. 

Soaring Chicken Farm Ministry is a faith based ministry. We hope to have our leaders that work directly with our clients align with our beliefs.


Please let us know your relationship with Jesus: (summary of your testimony)
Tenth Employee's Name

First Name*

Middle Name

Last Name*
Tenth Employee's Date of Birth*
Tenth Employee's Information

Schedule

Please complete the following section to the best of your knowledge. We understand that schedules change. Please simply indicate when and how you would like to make yourself available.

I would like to serve on a regular basis. *
Weekly
Bi-monthly
Monthly

Please check the days of the week you would like to work. If you are able, include the approximate time you would be able to arrive and depart on the days you have listed. Ex: (9-5:30)

Monday

Start am/pm

Finish am/pm
Tuesday

Start am/pm

Finish am/pm
Wednesday

Start am/pm

Finish am/pm
Thursday

Start am/pm

Finish am/pm
Friday

Start am/pm

Finish am/pm
Saturday

Start am/pm

Finish am/pm

Please also indicate the following:  


My offer to work expires:

*List the date you wish to no longer be contacted about working or write “no expiration”

Specific Areas of Interest:  

Please check all that apply.
Mentoring/working with children (requires fingerprinting)
Garden/Landscaping
Building/Construction Projects
Herd help (poop scooping, grooming, cleaning water troughs, etc)
Office/Administration
Professional Assistance
Fundraising
Anything and everything

We are open to your ideas. Please list and explain here:

Skills  


* Please list your strengths here

* Of the Skills you possess, which would you like to offer the farm?

Other Questions  


* How did you hear about us?

* Why would you like to work at Soaring Chicken Farm Ministry?

* What message would you like to convey, while working, to children and families at the farm?

* Tell us about yourself, if you’d like…. Interesting facts, outstanding talents, funny stories, favorite foods, hobbies, certifications, awards, achievements, etc.

This is for employees who want to work directly with children. 

Soaring Chicken Farm Ministry is a faith based ministry. We hope to have our leaders that work directly with our clients align with our beliefs.


Please let us know your relationship with Jesus: (summary of your testimony)
Please include a picture of yourself.

If attaching a picture online, please upload in jpeg format

  
Click to customize text box label *
Valid file types: JPG, GIF, PNG, and PDF
References:

Please provide three personal references other than relatives: 


Name: *

Phone: *

Relationship: *

How long known? *

Name: *

Phone: *

Relationship: *

How long known? *

Name: *

Phone: *

Relationship: *

How long known? *
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
Employee's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*

Emergency Contact's Relation to Participant

(Signature of Parent/Legal Guardian if Employee is Under 18)  

I am the parent or legal guardian of the Volunteer. I am of legal age and am freely signing this agreement. I have read this form and understand that by signing this form, I am giving up legal rights and remedies. 



By signing below the Parent or Court-Appointed Legal Guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information

Schedule

Please complete the following section to the best of your knowledge. We understand that schedules change. Please simply indicate when and how you would like to make yourself available.

I would like to serve on a regular basis. *
Weekly
Bi-monthly
Monthly

Please check the days of the week you would like to work. If you are able, include the approximate time you would be able to arrive and depart on the days you have listed. Ex: (9-5:30)

Monday

Start am/pm

Finish am/pm
Tuesday

Start am/pm

Finish am/pm
Wednesday

Start am/pm

Finish am/pm
Thursday

Start am/pm

Finish am/pm
Friday

Start am/pm

Finish am/pm
Saturday

Start am/pm

Finish am/pm

Please also indicate the following:  


My offer to work expires:

*List the date you wish to no longer be contacted about working or write “no expiration”

Specific Areas of Interest:  

Please check all that apply.
Mentoring/working with children (requires fingerprinting)
Garden/Landscaping
Building/Construction Projects
Herd help (poop scooping, grooming, cleaning water troughs, etc)
Office/Administration
Professional Assistance
Fundraising
Anything and everything

We are open to your ideas. Please list and explain here:

Skills  


* Please list your strengths here

* Of the Skills you possess, which would you like to offer the farm?

Other Questions  


* How did you hear about us?

* Why would you like to work at Soaring Chicken Farm Ministry?

* What message would you like to convey, while working, to children and families at the farm?

* Tell us about yourself, if you’d like…. Interesting facts, outstanding talents, funny stories, favorite foods, hobbies, certifications, awards, achievements, etc.

This is for employees who want to work directly with children. 

Soaring Chicken Farm Ministry is a faith based ministry. We hope to have our leaders that work directly with our clients align with our beliefs.


Please let us know your relationship with Jesus: (summary of your testimony)
Parent or Guardian's Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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