VCD Application for Children's Ministry Workers & Childcare Workers

VCD Application for Children's Ministry Workers & Childcare Workers
Vineyard Church of DuPage is committed to providing an abuse-free environment for our children. The following policies are designed to provide protective care for our volunteers, workers, and children.

1. Any person convicted of physical or sexual child abuse should not volunteer service in any of the children’s programs of Vineyard Church of DuPage.

2.Volunteers helping in the nursery and children’s programs are required to undergo a criminal background check. A person with a conviction of violent or sexual crimes will not be allowed to serve on the Children’s Ministry team or as a childcare worker.

3. Adult volunteers are required to immediately report to the children’s ministry leader any abusive or inappropriate behavior.
Please answer the following questions:
1. Do you agree to observe Vineyard Church of DuPage's policies regarding working with our children and youth?

yes no
2. Have you ever been convicted of physical or sexual abuse?

yes no
If you replied yes to the previous question, please explain:
3. Have you ever abused or sexually molested a child?

yes no
Full Legal Name
Gender
Any Other Names (maiden, alias, etc.)
Street Address
City
State
Zip
County
Phone #
Date of Birth

Month Day Year
Date
SSN
I have answered the above questions truthfully and agree to observe and abide by t he policies and safeguards of Vineyard Church of DuPage. I understand that this form will be kept on file indefinitely. I authorize Vineyard Church of DuPage to complete the necessary background checks to determine my eligibility to serve in the Children's Ministry or as a Childcare Worker.
Print Name
Signature

Clear
Date

Month Day Year
Date
Should be Empty:

VCD Application for Children's Ministry Workers & Childcare Workers

Please answer the following questions: