Dear church family,
In an effort to maintain a safe environment for our children at Sovereign King Church, the session has adopted the following Sexual Abuse Prevention Policy. Please take time to read the policy below. If you have any contact with children through any of our children’s activities, we are requesting that you and/or appropriate members of your family fill out the attached form and return it to the church office as soon as possible. This will enable us to complete appropriate background checks.
If you do not currently work with children in any formal way, but anticipate that you will in the future, we do request that you fill out the forms so that we will have them on file. You only need to complete the forms once. Please return a separate form for each member of your family that works with children. If you need additional forms please feel free to make copies.
Thank you for your prompt care in this matter.
In Christ,
Joseph Spurgeon
Sexual Abuse Prevention Policy -
Each church family will receive a copy of this policy and will be asked to familiarize themselves with its contents. All church staff and volunteers will be required to complete a screening form prior to participating in children/youth programs or activities. These forms will include personal history, church history, prior children/youth work, references and requests for a criminal background check.
The instructional objective of this church is to ensure that all staff and volunteers have a functional knowledge of issues pertaining to sexual abuse and comprehension of this policy.
In the event of an allegation, an elder will implement the enclosed Reporting and Response Procedure.
1. Individuals who have been convicted of child sexual abuse should not volunteer service in any church sponsored activity or program for children or youth.
2. Individual survivors of childhood sexual or physical abuse need the love and acceptance of this church family. Pastoral counseling is available.
3. All volunteers working with youth and children are required to be members or regular attenders of Sovereign King Church for a minimum of 6 months, or have been known to the staff/elders for a minimum of 1 year.
4. Adult volunteers should observe the “two person rule.†This requires that volunteers are never alone or secluded with children or youth without at least one other adult present.
5. Volunteers should immediately report any behaviors which seem abusive or inappropriate to their leader of their particular ministry.
Sexual Abuse includes any contact or interaction between a child and another person in which the child is being used for the sexual stimulation of the perpetrator and/or any additional person. This contact or interaction can include rape, molestation, forcing a child to look at or fondle the sexual parts of another person, and exploitation of a child through pornography or prostitution.
Expectations and Guidelines - On Site
1. Open Doors - All classroom doors must remain open when used in conjunction with children’s or youth classes and activities. (unless there are 2 teachers)
2. Alone Policy - No volunteer or staff member should be one-on-one with a student. If a teacher and student are left alone, the teacher should move to an area of public view, such as a doorway or hallway.
3. Bathroom Policy - Preschool bathroom doors should be partially open. A female adult will assist with bathroom and diaper changing duties.
4. Children’s Sunday School and nursery dismissal will coincide with the ending of the service or adult Sunday School.
5. Preschool and Nursery Dismissal Policy - Children will only be released to properly identified and pre-authorized adults.
6. Nursery Policy - Adequate supervision provided by a minimum of 1 adult per 6 children.
7. One-on-one counseling should only be performed by pastors or elders with open office door and/or in sight of other people.
Mission Statement - Church must be a safe place.
Church Staff and Volunteer Screening
This application is to be completed by all applicants for any position (volunteer or compensated) involving the supervision or custody of minors. This is not an employment application form. Persons seeking a position in the church as a paid employee will be required to complete an employment application in addition to this screening form. It is being used to help the church provide a safe and secure environment for those children and youth who participate in our programs and use our facilities.
Personal
Date__________________________________________________________________________
Name_________________________________________________________________________
Last First Middle
Identity must be confirmed with a state drivers license or other photographic identification.
Present Address___________________________________________________________
City____________________________________________________________________
State________________Zip_________________Home Phone ( )________________
Please indicate the type of youth or children’s work you prefer and why ______________
________________________________________________________________________
Do you have a current driver’s license?
____ Yes Number ______________________________________________________
____ No
Were you a victim of abuse or molestation while a minor: (see note below)
____ Yes
____ No
If you prefer, you may refuse to answer this question, or you may discuss your
answer in confidence with a pastor rather than answering it on this form.
Answering yes, or leaving the question unanswered, will not automatically
disqualify an applicant from children’s or youth work. As your church we are
sensitive to this issue and can offer pastoral counseling.
Have you ever been convicted of or pleaded guilty to a crime:
____ Yes (If yes, please explain – attach a separate page if necessary. Answering yes will not automatically disqualify an applicant from children’s or youth work. The elders and other leaders will use discretion when making this decision.)
________________________________________________________________________
____ No
Request for Criminal Records Check and Authorization
Sovereign King Church is requesting all staff and volunteers to authorize a criminal background check. This request will be used at the discretion of the pastor, elders, and those selected to lead children’s ministries.
I hereby authorize ___________________(or another third party vendor selected by the officers and employees of Sovereign King Church, their employees and representatives, and any law enforcement agency they contact; to obtain and/or release to the officers and employees of Sovereign King Church Church any information which pertains to any record of my convictions contained in any file or database, whether local, state, or national (duly expunged convictions notwithstanding). I hereby release the aforementioned parties from any and all liability resulting from such disclosure.
_______________________________________
Signature
_______________________________________
Print Name
_______________________________________
Print Maiden Name if Applicable
______________________________________________________________________________
Print all aliases
_______________________________________
Date of Birth
_______________________________________
Place of Birth
_______________________________________
Social Security Number
_______________________________________
Today’s Date
Record Sent to:
Sovereign King Church
1325 Lowell Ct
Clarksville IN 47129
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