Guiding Policies for Leaders with Minors

CHURCH

Guiding Policies For Leaders with Minors

Purpose Statement

At ______Church, we believe that the spiritual, emotional, and physical well-being of children and youth is vital. These “Guiding Policies” are intended to protect children and youth, as well as those who work with them, at our church. These policies will assist our congregation to provide a physically safe, emotionally secure, and spiritually nurturing environment for all who attend services or activities sponsored by ______Church. These policies will apply to all who work with minors at ______Church—volunteers, chaperones, and compensated workers.

General Guidelines

All leaders with children and youth are expected to observe these guidelines and be models of Christian standards and moral behavior.

A minor (child or youth) is defined as anyone under 18 years of age.

 All child-care or teaching settings will require a minimum of two adult leaders.

 All adult providers will fill out a “Volunteer Screening Form” or “Employment Application for Leaders with Minors” prior to beginning service.
These forms and applications will be kept in strict confidence and in a locked file cabinet, accessible only to the ministerial staff and approved support staff.

A background check will be conducted on all employed child-care providers before service begins. A background check may be conducted on volunteer

providers.

 Volunteers may not work with minors until they are members and have attended for six months.

 Equipping will be provided for all leaders before they begin their service.

These policies will be reviewed with all providers at the beginning of each new church year.

These policies will be monitored and updated by the Children’s Ministry Focus Group (newborn through 6th grade) and the Youth Ministry Focus Group
(grades 7-12). Any changes or updates to these guiding policies must be approved by the congregation in a business session.

VOLUNTEER SCREENING FORM

Church

CONFIDENTIAL

This form is to be completed for any volunteer position involving the supervision or custody of children and youth at______Church .This screening form is being used to help______Church provide a physically safe, emotionally secure and spiritually nurturing environment for children, youth and adults who participate in our ministries and use our facilities.

NAME ______PHONE ( ) ______. ______

ADDRESS ______

(Street) City State Zip

CURRENT DRVIER’S LICENSE NUMBER ______STATE______

SOCIAL SECURITY NUMBER ______- ______- ______

CHURCH HISTORY AND PRIOR EXPERIENCE

Please list any training, skills or talents that have prepared you to work with minors.

______

Please indicate previous experience working with minors in a church, include place and dates.

______

Please list previous non-church work involving minors (organization, type of work, and dates).

______

QUESTIONNAIRE

Please answer the following questions.
If you prefer, you may wish to discuss these matters in confidence with a
______Church staff minister.

1. Have you ever been convicted on a criminal offense?
YES NO

Comments:

______

2. Have you ever been accused or convicted of molesting or physically abusing another person?
YES NO

Comments:

______

PERSONAL REFERENCES

Please give two personal references that are not relatives or former employers.

NAME ______PHONE ( ) ______. ______

ADDRESS ______

(Street) City State Zip

RELATIONSHIP ______YEARS KNOWN______

______

NAME ______PHONE ( ) ______. ______

ADDRESS ______

(Street) City State Zip

RELATIONSHIP ______YEARS KNOWN______

BACKGROUND CHECK

I understand that a criminal background check and/or my driving record may be obtained as part of this screening process.

APPLICANT’S STATEMENT

The information provided above is correct to the best of my knowledge. I authorize the references, churches or
organizations to be contacted regarding my character, fitness and qualifications to work with minors.

I have read and agree to abide by these guiding policies of ______Church.
I will attempt, to the best of my ability, to model the love of Jesus Christ to those with whom I work.

SIGNATURE ______DATE ____ / ____ / ____

VERIFICATION OF INFORMATION

Application reviewed and references checked by:

SIGNATURE ______DATE ____ / ____ / ____

CHURCH POSITION ______

Approved: ______YES NO

EMPLOYMENT APPLICATION

FOR LEADERS WITH MINORS

Church

CONFIDENTIAL

This form is to be completed for any volunteer position involving the supervision or custody of children and youth at ______Church .This screening form is being used to help ______Church provide a physically safe, emotionally secure and spiritually nurturing environment for children, youth and adults who participate in our ministries and use our facilities.

NAME ______PHONE ( ) ______. ______

ADDRESS ______

(Street) City State Zip

CURRENT DRVIER’S LICENSE NUMBER ______STATE______

SOCIAL SECURITY NUMBER ______- ______- ______

CHURCH HISTORY AND PRIOR EXPERIENCE

Please list any training, skills or talents that have prepared you to work with minors.

______

Please indicate previous experience working with minors in a church, including place and dates.

______

Please list previous non-church work involving minors (organization, type of work, and dates).

______

QUESTIONNAIRE

Please answer the following questions.
If you prefer, you may wish to discuss these matters in confidence with a
______Church staff minister.

1. Have you ever been convicted on a criminal offense?
YES NO

Comments:

______

2. Have you ever been accused or convicted of molesting or physically abusing another person?
YES NO

Comments:

______

PERSONAL REFERENCES

Please give two personal references that are not relatives or former employers.

NAME ______PHONE ( ) ______. ______

ADDRESS ______

(Street) City State Zip

RELATIONSHIP ______YEARS KNOWN______

______

NAME ______PHONE ( ) ______. ______

ADDRESS ______

(Street) City State Zip

RELATIONSHIP ______YEARS KNOWN______

BACKGROUND CHECK

I understand that a criminal background check or my driving record may be obtained as part of this screening process.

APPLICANT’S STATEMENT

The information provided above is correct to the best of my knowledge. I authorize the references, churches, or
organizations to be contacted regarding my character, fitness, and qualifications to work with minors.

I have read and agree to abide by these guiding policies of ______Church.
I will attempt, to the best of my ability, to model the love of Jesus Christ to those with whom I work.

SIGNATURE ______DATE ____ / ____ / ____

VERIFICATION OF INFORMATION

Application reviewed and references checked by:

SIGNATURE ______DATE ____ / ____ / ____

CHURCH POSITION ______

Approved: ______YES NO

Reporting Procedures

For Allegations of Child/Youth Abuse

Church

1. All allegations of abuse will be taken seriously by the church leadership.

 Listen supportively.

Hear the victim out—do not minimize the allegation.

Do not judge the allegation negatively or positively.

Do not discuss the allegation with anyone except those who need to know in order to respond.

2. When a case of abuse is suspected, the leader will immediately insure the safety of the child, report the incident to the immediate supervisor, and notify the
church staff. The person reporting the allegation will document pertinent information surrounding the event. Investigations will be handled discreetly.

3. In the event that an allegation is brought to the church leadership, the appropriate persons will be notified: the church’s lawyer, the church’s insurance
carrier, and Child Protective Services.

4. Any conduct that seems inappropriate for providers is to be confronted immediately and reported to one’s supervisor or leader.

5. In the event of an allegation against a paid church employee or a volunteer, that person will be monitored closely by other leaders until an investigation
is completed.

6. The parents of a child involved in an allegation of abuse will be notified immediately.

7. When necessary, leaders and family members will seek appropriate medical personnel to examine the minor as soon as possible.

8. High regard for each person’s rights, privacy, and confidentiality will be maintained at all times.

9. An Incident Record must be filled out if child abuse is suspected. The entire process of how an allegation is managed will be thoroughly documented
by those leaders and kept on file.

10. A spokesperson designated by the senior pastor will handle all inquires by the media and inform the congregation, preferably using a prepared statement
that will safeguard privacy, accuracy and confidentiality.

GUIDELINES FOR PRESCHOOL LEADERS

Church

Note: We live in an age where child abuse is a reality in our society. The church must deal with this issue by taking steps to protect children in our care. ______Church has implemented a policy that will safeguard our children while promoting a positive, nurturing environment for ministry to them. The following guidelines are to be followed by anyone who has custody or supervision of preschoolers.

 Two Person Rule – Two adult leaders must be present in each preschool room at all times. This accomplishes several important objectives:
reduces the risk of injury, provides an appropriate teacher/pupil ratio, reduces the risk of child abuse, and reduces the risk of unfounded claims of abuse.
Teams of workers cannot be from the same family.

Only assigned leaders may be in the preschool area – There are two exceptions to this rule: nursing mothers and parents called to the preschool to
calm an upset child.

Only parents (or those approved by parents) may receive their child from the preschool area – Preschool leaders will release children to parents only
(or a specific person designated by parents). A claim check system is utilized, and parents and teachers are instructed in the use of the system.

 Corporal punishment – Hitting, spanking or other forms of punishment involving physical pain are never appropriate at______Church.

 Report suspected child abuse – Any suspected child abuse must be reported to a preschool leader or staff member immediately. Follow the reporting

procedures adopted by the church.

 Provide exemplary leadership at all times – All leaders are to model the love of Christ while leading children and avoid behavior which may be
misconstrued as negative or inappropriate. This is needed to maintain parental confidence and avoid mistaken allegations.

 Auto Safety Form – Leaders who transport preschoolers for any church function must complete and sign an Auto Safety Form.

 Trip Permission Slip – Permission slips must be signed by parents or guardians giving approval for all trips and activities away from the church building.

 Failure to follow guidelines – Leaders who disregard these guidelines may be reassigned or relieved from duty at the discretion of church leaders.

GUIDELINES FOR CHILDREN’S LEADERS

Church

 Two Person Rule – Two adult leaders must be present in each children’s room at all times. This accomplishes several important objectives:
reduces the risk of injury, provides an appropriate teacher/pupil ratio, reduces the risk of child abuse, and reduces the risk of unfounded claims of abuse.
Teams of workers cannot be from the same family.

 Corporal punishment – Hitting, spanking or other forms of punishment involving physical pain are never appropriate at ______Church.

 Report suspected child abuse – Any suspected child abuse must be reported to a children’s leader or staff member immediately. Follow the reporting

procedures adopted by the church.

 Open Door Policy – All gatherings of children at ______Church are open door. This means that pastors, parents, and church
members have the right to observe any activity which involves children.

 Auto Safety Form – Leaders who transport children for any church function must complete and sign an Auto Safety Form.

 Trip Permission Slip – Permission slips must be signed by parents or guardians giving approval for all trips and activities away from the church building.

 Failure to follow guidelines – Leaders who disregard these guidelines may be reassigned or relieved from duty at the discretion of church leaders.

GUIDELINES FOR YOUTH LEADERS

Church

Note: We live in an age where abuse is a reality in our society. The church must deal with this issue by taking steps to protect youth in our care. ______Church has implemented a policy that will safeguard our youth while promoting a positive, nurturing environment for ministry to them. The following guidelines are to be followed by anyone who has custody or supervision of youth.

 Two Person Rule – Whenever possible, a youth will not be in the primary care of only one adult. This accomplishes several important objectives:
reduces the risk of injury, provides an appropriate teacher/pupil ratio, reduces the risk of child abuse, and reduces the risk of unfounded claims of abuse.
Teams of leaders cannot be from the same family.

 Corporal punishment – Hitting or spanking a youth (or any form of punishment) is never appropriate at ______Church. Workers must

consult the ministerial staff if help with discipline is needed.

 Report suspected child abuse – Any suspected child abuse must be reported to a youth leader or staff member immediately. Follow the reporting procedures

adopted by the church.

 Provide exemplary leadership at all times – All leaders are to model the love of Christ while leading youth and avoid behavior which may be

misconstrued as negative or inappropriate. This is needed to maintain parental confidence and avoid mistaken allegations.

 Open Door Policy – All gatherings of youth at ______Church are open door. This means that pastors, parents, and church
members have the right to observe any activity which involves youth.

 Auto Safety Form – Leaders who transport youth for any church function must complete and sign an Auto Safety Form. Youth participants may not

transport other youth for church-sponsored events.

 Trip Permission Slip – Permission slips must be signed by parents or guardians giving approval for all trips and activities away from the church building.
For ongoing types of trips, blanket permission slips will be kept on file.

 Individual Counseling – Any adult counseling a youth should do so in a public place in view of others. When possible, females should counsel females
and males counsel males. Youth who might need long term counseling should be referred by a staff member to an appropriate professional in
the community.

 Confidentiality – There are limits to confidentiality when ministering to and with youth. Youth leaders must report to a staff minister if a minor
discusses harming him/herself or others, committing a crime or being abused. Conferring with a minister on these issues is not considered breaking
a confidence. This guideline is in compliance with state law.

 Dating or Sexual Involvement – No adult youth leader is to date or be romantically or sexually involved with a youth. There are no exceptions to this

guideline.

 Failure to follow guidelines – Leaders who disregard these guidelines may be reassigned or relieved from duty at the discretion of church leaders.

AUTO SAFETY FORM

Church

This form is intended for workers who have responsibility to transport children or youth by personal auto and/or church van or bus. Only persons with valid Virginia driver’s licenses and valid personal auto insurance may transport others as part of church activities.

Please answer all questions. The information will be kept in confidence and will not be disclosed to unauthorized persons.

Are you now a licensed driver? YES NO

Please present your license to the supervising staff person so it may be copied for the records.

Do you currently have personal auto insurance? YES NO

Please present your proof of insurance card so it can be copied for church records.

Have you been ticketed for driving violations (parking tickets not included) within the past two years? YES NO (If yes, explain on back.)

Agreement to notify of driving event – If in the future my driver’s license is suspended or revoked, if I am ticketed for reckless driving, if I have alcohol or drug related charges pending, or if my personal auto insurance is canceled or not renewed, I agree to notify ______Church.
NOTE: Being ticketed for a minor offense does not automatically disqualify a leader from transporting people.

Seat belt usage – I agree to transport persons only in passenger seats equipped with appropriate seat belts and child safety seats. I agree to require seat belt usage at all times. NOTE: If buses used to transport persons are not equipped with seat belts, this rule does not apply.

Safe Vehicle – I agree to transport persons only in vehicles that are in safe operating condition.

I have truthfully responded to the questions above. I agree to notify the church if any of the driving events listed above occurs.

Signature______Date______

Please print name______

ILLNESS/ACCIDENT/INCIDENT RECORD

Church

Name of Child: ______

⁯ Illness (complete Sections A, D, E)

⁯ Accident (complete Sections B, D, E)

⁯ Incident involving child (complete Sections C, D, E)

Ministry or activity in which the child was involved: ______

Section A – Illness

Date: ____ / ____ / ______Time Commenced: ____:_____ AM / PM

Nature of illness: ______

______

Section B – Accident

Date: ____ / ____ / ______Time Commenced: ____:_____ AM / PM

Nature of injury: ______

______

Activity during which accident occurred: ______

Supervisor of activity: ______

Other leaders present: ______

______

Section C – Incident

Date: ____ / ____ / ______Time Commenced: ____:_____ AM / PM

Describe the incident in detail: ______

______

Section D – Treatment or Care Provided

Describe in detail how the child was treated or the situation was handled:

______

Section E – Notification and Signatures

Was parent or guardian notified? YES NO

Name of parent or guardian notified:______
Time Commenced: ____:_____ AM / PM

Name and signature of person supervising at the time:

Name: ______Signature: ______

Name and signature of staff member:

Name: ______Signature: ______

MEDICAL INFORMATION FORM

Church

(Please type or print clearly)

Name______Age______ Male  Female Weight______

Parent/Guardian______

Phone ( ) ______. ______Bus. Phone ( ) ______. ______

Parent/Guardian______

Phone ( ) ______. ______Bus. Phone ( ) ______. ______