Child Abuse Prevention Policy
Grace Bible Church, Wappingers Falls, NY
Introduction & Purpose
Children are extremely precious to God and to us. Jesus welcomed them to
Himself (Matthew 18:1,2) and used them as an example of the humility and trust
that one must have in order to enter the kingdom of heaven (Matthew 18:3,4). He
also gave stern warning about causing "one of these little ones who believe
in Me to stumble. . .".
A church should be a safe place for any child, but tragically that is not
always the case. Because Christians are saved sinners there are those who
profess Christ that will stumble into sin in their treatment of children. There
are also those that make false professions of faith that will give into their
sin nature. There are also those who consciously and falsely present themselves
a good Christians because they specifically target churches in order to sinfully
The Church must work hard to protect children and prevent others (whether
adults or other children) from abusing them in any manner whether it be
physical, mental or sexual abuse. As part of our effort to protect our children,
Grace Bible Church has established policies and procedures for our Nursery,
Children’s and Youth ministries which are to be taught and upheld. These
policies will be reviewed on a regular basis for effectiveness and conformity to
any changes in law.
Statement of Covenant
In order to demonstrate our love by fulfilling the commands of our Lord Jesus
Christ, we, the members and congregation of Grace Bible Church, pledge to
conduct the ministries of this church in ways that assure the spiritual growth,
safety and welfare of all who come. Special attention will be given to the
various ministries to our children and youth to prevent any sort of abuse and
protect our workers from false charges. We will follow reasonable safety
measures in the selection and recruitment of workers; we will implement prudent
operational procedures in all programs and events: we will educate all of our
workers with children and youth regarding the use of all appropriate policies
and methods (including first aid and methods of discipline); we will have a
clearly defined procedure for reporting a suspected incident of abuse that
conforms to the requirements of state law; and we will be prepared to cooperate
with any investigation by law enforcement agencies and to respond to any media
inquiries if an incident or accusation occurs.
Volunteer Children’s / Youth Worker
Home Phone: _________________ Work Phone: _____________ Cell Phone:
Special interests, hobbies and skills:
Why would you like to volunteer to work with children and / or youth?
What qualities do you have that would help you work with children and / or
Describe the level of commitment you can make to the ministry for which you
Would you be willing to help transport children / youth to activities?
Do you have a valid New York State Driver’s License? _____________
Do you have any points against your license? If so, how many and for what
Have you ever been charged, convicted of, or pled guilty to a crime, either a
misdemeanor or a felony (including, but not limited to drug related charges,
child abuse, other crimes of violence, theft)?
Please explain: (Make an appointment to talk with a GBC
Children’s / Youth Worker Policies
Please answer each of the following questions:
1. As a volunteer working with children or youth at Grace Bible Church, do
you agree to observe and abide by all the policies of Grace Bible Church
regarding children or youth ministries?
2. As a volunteer working with children or youth at Grace Bible Church, do
you agree to submit to a criminal records check?
(If there is any criminal activity in your past, please discuss it with a GBC
Pastor BEFORE the background check is sent in. All information is
kept confidential and the records will be kept under lock and key).
3. As a volunteer working with children or youth at Grace Bible Church, do
you agree to discuss with a GBC pastor any previous convictions or formal
accusations of Child Abuse?
4. As a volunteer working with children or youth at Grace Bible Church, do
you agree to discuss with a pastor of Grace Bible Church your experience, if
any, as a survivor of child abuse?
5. As a volunteer working with children or youth at Grace Bible Church, do
you agree to observe the "Two Worker Rule" at all times?
6. As a volunteer working with children or youth at Grace Bible Church, do
you agree to participate in training and education events provided by the church
related to volunteer assignments?
7. As a volunteer working with children or youth at Grace Bible Church, do
you agree to promptly report abusive or inappropriate behavior to the ministry
director or a pastor?
8. As a volunteer working with children or youth at Grace Bible Church, do
you agree to provide GBC with three character references of people that have
known you longer than 5 years.
I have read this Participation Covenant, and I agree to observe and abide by
the policies set forth above.
Signature of Applicant
Personal Character References
Please provide information on at least three people that have known you
longer than 5 years that can attest to our character. Only one of the three may
be related by blood or marriage .
Nature of Relationship
Nature of Relationship
Nature of Relationship:
Nature of Relationship:
Reference Check Form
Reference Phone Number:
1. What is your relationship to the applicant?
2. How long have you known the applicant?
3. How well do you know the applicant? Explain.
4. How would you describe the character applicant in each of these areas?
E. Patience J. Helpfulness
5. How would you describe the applicant’s ability to relate to children
6. How would you describe the applicant’s ability to relate to adults?
7. How would you describe the applicant’s ability to follow the leadership of
8. How would you describe the applicant’s ability to provide leadership to
9. Do you know of any characteristics that would negatively affect the
applicant’s ability to work with children and/or youth? If so, please describe.
10. How comfortable would you be if the applicant were working with a child
you love (your own children, grandchildren, nephews, nieces, etc.).
11. Do you have any knowledge that the applicant has ever been convicted of a
crime? If so, please describe?
Reference inquiry completed by:
Authorization and Request for
Criminal Records Check
I, ________________________________, hereby authorize Grace Bible Church,
Wappingers Falls, NY, to request ____________________________________
police/sheriff’s department to release information regarding any record of
charges or convictions contained in the files, or in any criminal file
maintained on me, whether said file is a local, state, or national file, and
including but not limited to accusations and convictions for crimes committed
against minors, to the fullest extent permitted by state and federal law from
any pertinent law enforcement agency / department. I do release said
police/sheriff’s department from all liability that may result from any such
disclosure made in response to this request.
(All information received is kept confidential and records kept under lock
Signature of Applicant
Print Applicant’s full name:
Print all other names that have been used by applicant (if any)
Date of Birth: _________________ Place of Birth
Social Security number (if required by law enforcement agency)
Driver’s License Number _______________________ State issuing license
License expiration date: ________________________
Request sent to:
(This form may be replaced by any equivalent form supplied by the particular
enforcement agency / department contacted)