Applications: New Volunteer/Childcare Worker Agreement (Adult)

Thank you for being willing to serve! This agreement is just one small part of helping us keep our ministries to children and youth safe, and we appreciate you taking a little time to complete this step. Please read and answer each question below. For issues or questions, contact Amy Thompson at amy@gccnewton.com or 316-283-2554.

Your name *

Last name

Email address *

What is today's date? *

Personal Information

Phone number *

Phone type

Address *

Country

Street Address

Apt/unit/box (optional)

City

State

Postal code

Gender *

Birthday *

Only one agreement is required per year for anyone serving. If you fill out an application for one area of ministry, this will cover you for serving in another area. In which area(s) do you plan to serve? Check all that apply. *

Nursery

Children's Sunday School

AWANA

Transform Student Ministries (Sunday mornings/evenings or Wednesday)

Childcare (for Bible studies or other events)

Summer Quest

Other

Life, Faith & Church

Do you regularly attend GCC? *

Yes

If you attend GCC, about how long have you been attending?

If not, where do you currently attend church?

By God's strength, I commit to live by spiritual principles that please God and to make choices that set a positive example, especially in the areas of drugs, alcohol, choice of entertainment and sexual purity (including abstinence until marriage). *

See Ephesians 4:17-5:21 & I Corinthians 10:23-11:1

Yes

Have you read and are you willing to teach according to Grace Community Church's Statement of Faith? *

A copy of our Statement of Faith from our church by-laws is available here: https://gccnewton.com/faith-statement-1

Yes

Please briefly describe when and how you became a Christian. *

What are you currently doing to maintain and grow your spiritual life with Christ? *

List other churches (including city & state) you have attended regularly during the past five years. *

Please submit the name and email address for 1-2 references (not family members) whom we may contact concerning your character and abilities in working with children and youth. *

Please include: name, phone number and email address for each.

Pornography & Abuse

The following questions are for the purpose of providing a safe environment for our children & youth. Your answers are held strictly in confidence.

Have you ever been convicted of, or treated for, any form of substance abuse? *

Yes

Have you ever been charged, accused or convicted of any form of child abuse, pornography, child molestation, domestic violence, or any other crime or sexually-related crime? *

Yes

Have you viewed pornography in the last 12 months? *

Yes

Have you EVER viewed child pornography? *

Yes

Have you ever been arrested for a criminal offense EXCLUDING minor traffic violations? *

Yes

Have you ever been reported to a social services agency, law enforcement authority, child abuse registry, or similar organization regarding abuse or misconduct involving children? *

Yes

Is there any other information that would call into question your ability to work with children or youth? *

Yes

If you answered "YES" to any of the above group of questions, please explain in the space provided. If you marked "NO" for all questions, please answer with "N/A". *

Child/Youth Protection Guidelines Agreement

The following guidelines have been established and are to be followed by every individual who serves in children's and youth ministry. Mark "YES" for each guideline to indicate you have read & agree to abide by it.

General

All who serve must complete an annual agreement and be approved by a ministry staff member of Grace Community Church. *

Approval process may also include an interview and reference checks, and will require a background check once every four years.

There should be a minimum of two volunteers/workers in any room with children/youth. At least one should be an adult. *

If it is momentarily necessary that only one volunteer be in a room with children, the door of that room shall remain at least slightly open or have a window that will allow others to look in.

Personal cell phone use should be kept to a minimum so as not to interfere with your responsibilities. *

Phones may be kept on a counter in the room. If use becomes a problem, the designated coordinator may require the phone be left in another location (i.e. check-in desk, vehicle, purse, etc.).

It is recommended that a third volunteer/worker (not related) should be in the classroom for spouses or families serving together. *

Safety

Children 1st grade and younger (2nd grade and younger at AWANA) should be dropped off and picked up by a parent/guardian. *

Where required, parents must present their printed security tag to check-in staff. If another person is to pick up the child in the parents' place, the parent/guardian must give their printed security tag to that person. Check-in staff will take children to and from their class and the check-in station.

Procedures for emergency situations (fire, tornado, etc.) are posted and shoud be reviewd regularly. Basic first aid kits are available in each classroom as well as in the Resource Room, check-in stations and the Connection Desk. *

It is recommended that teachers/leaders conduct practice drills with their students. Contact a parent when an injury occurs, report it to the ministry director in charge, and complete an incident report form for any accident.

If an injury or behavioral incident occurs, you should contact a parent, report the incident to the ministry leader in charge, and complete an incident report. *

Physical Contact

Use proper judgement for appropriate physical contact. *

Touching and hugging should be done in the presence of another volunteer and in an open classroom or area. Kissing, extended hugging and tickling, or carrying or sitting an older child on your lap is prohibited.

One-on-One Situations

When taking young children to the restroom, only enter the restroom to assist a child when absolutely necessary and keep the outside door slightly open. *

If a private conversation needs to take place between you and a child/youth for things such as salvation, leave the classroom door open, talk privately in a public area or have another volunteer nearby with you. *

Outside Contact/Transportation

If a volunteer/worker desires to meet with a child/youth individually outside of normal ministry programming, specific permission from a parent should be received first. The meeting should take place in a public setting. *

When transporting children/youth for any reason, a volunteer should never be in a vehicle alone with a child/youth. *

If a volunteer/worker desires to text, email or connect over social media parental approval is recommended. *

Parental consent forms are required for each child participating in church-sponsored activities or trips. *

Abuse/Confidentiality

You should report any suspected/known child abuse to the Children's Ministry Director or a pastor of Grace Community Church. *

Respect the confidentiality of a child/youth when they share personal things with you except in cases where you suspect physical, sexual or verbal abuse, neglect, sexual misconduct between minors, rape, self-harm, pornography, drug use, etc. *

In those cases, report to and seek counsel from the director of children’s or youth ministry or a pastor of Grace Community Church.

Authorization

Your Agreement *

The responses I have provided in this application form are complete, truthful and accurate to the best of my knowledge.

I understand that Grace Community Church will require a background check once every 4 years. I hereby authorize Grace Community Church and its representatives to make inquiries concerning my background in connection with evaluating information I have provided on this application form and in the application process, which may include checking references, a consumer or investigative consumer report, a driving history (including any traffic citations), a social security number verification, present and former address, a criminal and civil history/records check and request from any central registry of child abusers to be generated for volunteer and/or employment purposes.

I hereby authorize all persons associated with me, including churches, employers, law enforcement, licensing and social services agencies, to release any information contained in their files concerning me to Grace Community Church and its representatives and release Grace Community Church and all others from liability in connection with the same.

I commit myself to the ministry of Grace Community Church. I affirm that I will comply with all policies and procedures of Grace Community Church.

I understand my information will be reviewed by a representative of Grace Community Church, who may contact me for further information as needed, and who may consult pastoral staff in strictest confidence only as needed. I am entitled to a complete copy of any background information report of which I am the subject upon my request to Grace Community Church, if such is made within a reasonable time from the date it was produced.

Your Signature *

Type your full name below as your electronic signature to authorize the above statements.

Accuracy and Consent *

If we learn that any of your answers do not accurately represent your situation or that you were not completely truthful about your answers we reserve the right to ask you to step down from serving until we fully understand your situation. Do you understand and consent to this policy?

Yes

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Grace Community Church
info@gccnewton.com
3162832554