Child Protection Form

Name

This address will receive a confirmation email

Phone

Address

Please check all that apply to you:

I have read, understand, and agree to comply with the church’s Child Protection Policy. I have never engaged in physical or sexual abuse of a child. I have no legal charges pending against me. I have no criminal record. I have described my criminal record in the next section.

Details of any criminal record:

The Office Administrator will email you a link to complete a criminal records check by Trusted Employees online. The results will be maintained confidentially, accessible only to the Senior Minister, the Associate Minister, and the Director of Membership & Administration. A criminal history will not necessarily disqualify you except for certain crimes listed on our Child Protection Policy. Other types of crimes will be evaluated on a case-by-case basis. If you have a criminal record, please share it below, including what the crime was, when it happened, and any context you think we should know.

Electronic Signature (Your name here will serve as your signature for this form.)

Date:

For New Volunteers Only:

Please provide the name, email, and phone number for two references. One should be a church member or friend who has participated at the church for at least two years. The other may be someone from outside the church.

Church Reference:

Second Reference:

Description

Please fill out this form and click submit.

Child Protection Form

Description

Please Fix the Following