Skipwith United Methodist Church
Policy on Facility Use
(Adopted by the Board of Trustees April 19, 2015)
The property and facilities (the facility) of Skipwith United Methodist Church
(SUMC) are maintained and overseen by the Board of Trustees as stated in The
Book of Discipline of the United Methodist Church, as revised from time to time.
The primary use of the facility is to carry out the ministries of SUMC. In addition,
we consider all of the areas of the facility to be sacred space in the sense that
they are set apart for the purpose of helping to advance the church’s mission to
make disciples of Jesus Christ.
Scheduling
The church has many events and programs that are provided to the community
and our congregation. The Office Administrator keeps the calendar of events at
SUMC and is the primary contact for scheduling use of the building or other
property.
Space is a valuable resource to SUMC. Space will be assigned in a way that best
serves church goals while seeking to meet the needs of church members and the
surrounding community.
All meetings and gatherings at SUMC must be scheduled in advance with the
Office Administrator. Except for ongoing meetings, which SUMC has approved
and scheduled for a year at a time, any outside group event (i.e. planned by a
person or group who is not a church member) cannot be scheduled more than 6
months prior to the date of the event.
Space is offered, as available, to the community for not-for-profit organizations
and enterprises. However, SUMC events have scheduling priority, and empty
rooms are not necessarily available for use. Space shall not be made available to
for-profit entities of any type.
To avoid incurring a cancellation fee, event cancellations must be made at least 24
hours in advance by contacting the Office Administrator.
Adopted by Board of Trustees April 19, 2015
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Storage Space
Space allocated in closets or storage areas is limited and is not available to groups
without specific written approval. No items may be stored on the SUMC campus
without the assistance of the property manager, who will obtain permission from
the appropriate parties.
Facility Use Agreement
Outside groups shall execute a Facility Use Agreement and may be required to
furnish a certificate of liability (2weeks in advance) and/or a facility usage fee.
The Facility Use Agreement and accompanying Facility Reservation Request may
be downloaded from the church web site at www.skipwithumc.com
Recurring Events
SUMC allows a limited number of community-based recurring events to be
scheduled in its facilities. Requests for recurring events shall be made through
the Office Administrator who will see that the Board of Trustees is given the
opportunity to act on each request. The Board of Trustees has the sole discretion
to authorize recurring events on behalf of SUMC.
Room Set-up and Condition
Each room has a standard set up. Any group that desires a room to be set
differently from the standard shall specify the room set on the Facility Request
Form. Each user is required to return the room to its standard set before
departure. Furnishings may not be moved from one location or room to another
without notification and approval from the Office Administrator.
Rooms are cleaned regularly. Each group is expected to exercise due care in all
areas of the church and to clean up after use. Any problems shall be reported to
the church office.
All heating and air conditioning units are computer programmed and centrally
controlled. Please notify the Office Administrator of any problems or concerns
with heat or air conditioning.
Adopted by Board of Trustees April 19, 2015
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Operating Hours
Our church office is open Monday-Friday, 8 am – 2 pm, September through May
and 7:30 am – 3 pm, Monday – Thursday, June through August. Meetings shall
end no later than 9:30 p.m. Special arrangements must be made if meetings or
events will extend past these hours. Additional charges will apply.
Office Equipment
SUMC staff and approved volunteers shall be the only authorized users of office
equipment, including but not limited to copiers, binding machines, facsimile
machines, scanners, postage meters, and other similar devices. Others may use
this equipment with authorization of staff.
Signs and Other Communication by Groups
Any notices to be circulated or posted for the church community should be
submitted to the Office Administrator before posting or circulation. Adhesive,
tacks, pins, nails or any other similar device placed on the walls, floors, doors, and
ceilings (e.g. any surface that is not glass) of the church are prohibited.
Banners, crosses, or other worship/religious artifacts or related items that the
church has in place shall not be removed.
Kitchen Access
Groups wishing to use the kitchen may do so only if specifically approved in
writing. If there is a need for additional staff coverage, the group will be
responsible for paying the church or staff member. Fees and staffing needs will be
discussed prior to approval.
Children
SUMC encourages family ministries. Nurseries are provided for most churchbased groups and events. Any child care providers, whether volunteer or paid,
shall be governed by the Skipwith United Methodist Church Child Protection
Policy.
Children may never be left unattended on the SUMC campus. Qualified adult
supervision of children under the age of 18 is required at all times on all SUMC
properties and each group is subject to the terms of the attached Skipwith United
Methodist Church Child Protection Policy.
Adopted by Board of Trustees April 19, 2015
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Security and Emergencies
Under certain circumstances, group representative(s) will be issued a key to the
building and/or to inside facilities. All persons with keys are responsible for
securing the building and safe guarding any key that they have been issued.
911 may be dialed from all phones to REPORT A FIRE, POLICE, OR MEDICAL
EMERGENCY. The following information shall be displayed at all phones: 2211
Skipwith Rd 23294
Information Systems and A/V Equipment
Information system devices including but not limited to computers, phones, and
office equipment shall not be loaned out to any individual or group. Equipment,
excluding staff-assigned laptop and/or a/v equipment, shall remain on the SUMC
campus at all times.
Groups and their guests are not permitted to use SUMC computers but internet
connection may be available depending on the room being used. Availability of
equipment and connection is not guaranteed. Call the Church Administrator for
further information.
TVs, VCRs, CD players, DVD players, overhead projectors, screens, computer video
projectors, laptops, easels with or without paper charts, and other audio/visual
equipment may be available for use. Audio/visual equipment is not to be
relocated within the facility without prior approval.
SUMC has a sound system which requires operation by authorized persons. Users
shall contact the Office Administrator if such services are needed and to
determine availability. Once a request form is submitted, contact will be made
with our sound consultant and a fee for use will be determined. Availability of
equipment is not guaranteed. Call the Office Administrator for further
information.
Adopted by Board of Trustees April 19, 2015
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Liability
SUMC is insured for property and casualty liability. If requested to do so, outside
groups shall provide SUMC with a Certificate of Insurance listing SUMC as
additional insured at least 2 weeks prior to the event.
Fees and Expenses
Each user is responsible for the security of his or her own valuables. Therefore,
we ask each person to pay close attention outside. Groups (including those that
offer musical, dance, receptions and one-time special events) that use SUMC
facilities may be charged usage fees according to the following schedule:
Space
Fee for 1 block of time
(8 am – 12 noon; 12 noon-4 pm; or 5 pm-9 pm)
• Sanctuary (160 people max)
$100.00
• Social Hall (180 people max)
$ 50.00
• Social Hall with Kitchen
$125.00
(must be approved in writing)
• Room 106 ( 35 people max) $ 30.00
In addition, where use of the facility calls for additional set up, custodial or
kitchen support, there will be a charge of $15.00 per hour.
Groups that damage the facilities or equipment will be required to reimburse
SUMC for replacement or repair cost.
Other Rules
 All SUMC buildings are smoke-free. No smoking is to occur immediately
outside of any gathering room, classroom, or worship area.
 No alcohol consumption or illegal drug usage or firearms will be permitted
anywhere on the SUMC campus.
 Outside groups are not allowed to solicit funds or hold fund raising events
on the SUMC campus.
 Any individuals or groups in violation of the terms of this policy will be
asked to leave the campus.
Adopted by Board of Trustees April 19, 2015
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Skipwith United Methodist Church
Facility Use Agreement
This Agreement made and entered into by and between Skipwith United Methodist
Church (hereinafter referred to as the church) and ____________________
(hereinafter referred to as the group) provides the following terms and conditions:
1. The authorization for use of the church facilities is for the following dates and
times:
This authorization may be cancelled at any time or not renewed at the
discretion of the church, subject to the terms of the attached Facility Use Policy.
2. By signing this Agreement, your group assumes all legal responsibility for the well
being of adults and children in or associated with your group and you certify that
you have received and read this Facility Use Agreement, the Policy on Facility Use
along with the Skipwith United Methodist Church Child Protection Policy (both
attached) and communicated the terms of those documents to the group.
3. The area of the church grounds and buildings to be used includes the assigned
room(s), restroom facilities, hallways, and other reasonable use of the church as
is required by the nature of your group. The church does not provide storage
space for materials or equipment without a specific agreement.
4. Children who accompany parents or other adults to events or meetings must be
supervised by a responsible adult at all times in accordance with all of the terms
of The Skipwith United Methodist Church Child Protection Policy. Under no
circumstances will youth or children (under the age of eighteen) be left
unattended.
5. Any damage to the church grounds, the building, or its contents is the
Responsibility of the group using the facility and should be reported to the
church.
6. The contact persons listed on this Agreement will be responsible for the security
and cleanliness of the parts of the building used by the group. When your
meeting is over, we expect the part of the building you used to be returned to its
original set up and be at least as clean and neat as it was when you arrived for
your meeting.
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Adopted by Board of Trustees April 19, 2015
7. If indicated below, your group is expected to provide insurance for your members
and those who are connected with the group. Whether or not the group has
insurance, you and your group will hold Skipwith United Methodist Church
harmless in any action that may be brought by a user of the church facilities for
recovery of expenses incurred in personal injury or loss of property on the
church premises.
8. Smoking is not permitted in any part of the church building. A designated
smoking area is in the rear of the building at the northeast corner. Containers
used for cigarette/cigar butts are provided and should be maintained.
9. The church kitchen will be locked and not available for use unless the group
has specifically arranged in writing for use of the kitchen.
10. Each group must furnish its own supplies (coffee, sugar, paper cups, napkins,
paper towels, etc). Please remember that storage of these items is not
provided nor guaranteed. Groups may not use any church supplies.
11. Each group assumes full responsibility to lock doors and turn out the lights
after the scheduled meeting.
Note: The Skipwith United Methodist Church Child Protection Policy (attached)
requires that there be two (2) adults with whenever possible when children are
cared for in a church setting (i.e. nursery). These adults must be over the age of
eighteen (18) and should NOT be related to each other by blood or marriage.
The terms and conditions outlined above and contained in the attached Facility
Use Policy are mutually understood and agreed to this date:
, 2015.
Name of group using Skipwith
UMC:________________________________________
Day & time of your meeting:
______________________________________________
Assigned Meeting room:
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Adopted by Board of Trustees April 19, 2015
Contact (responsible) person
Name (please print)_______________________________
Mailing Address _________________________________
preferred phone #:_______________________________
email address____________________________________
Signature:
________________________________________________________________
Second contact (responsible) person
Name (please print):_______________________________
Mailing address ___________________________________
preferred phone #_________________________________
email address ____________________________________
Signature:
_____________________________________________________________
The undersigned has or have been issued keys to SUMC as follows:
Key #
Name
Key #
Name
And agrees not to duplicate or share this key.
Kitchen Use
Terms of Applicable Fees
Verification of insurance (if applicable)
Adopted by Board of Trustees April 19, 2015
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Skipwith United Methodist Church
Facility Reservation Request
(Note: This form is a request to use space at SUMC. A reservation of space is
confirmed only after the church has received:
• Reservation Request Form
• Signed Facilities Use Agreement
• Insurance Certification (if requested)
• Fee for use (if applicable)
PLEASE COMPLETE ENTIRE FORM
Name of Organization
Responsible Person
Non-Profit Status
Federal ID No.
Address
Phone
Fax
E-mail
Organization’s Purpose
Event Name and Description
Date of Request
Contact Person’s Name
Date(s)
Start Time
End Time
Will the event be recurring?
One time only
Monthly
Weekly
Multiple days
Which day of the week? (circle one)
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
Room(s) Requested
Sanctuary
Social Hall
Nursery
Social Hall with Kitchen (must be approved in writing)
Classroom(s)
Anticipated Number of Participants
Will a participant fee be charged for the event?
Yes
No
Will food or drink be consumed?
Yes
No
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Adopted by Board of Trustees April 19, 2015
Special Needs or Requests
Set Up Instructions
Adopted by Board of Trustees April 19, 2015
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CHILD PROTECTION POLICY AND PROCEDURES
For
Skipwith United Methodist Church
2211 Skipwith Road
P.O. Box 32104
Richmond, VA 23294
(804) 2706560
[email protected]
Adopted
by
The Board of Trustees
of
Skipwith UMC
Supersedes all other policies
and procedures on this topic.
CHILD PROTECTION POLICY AND PROCEDURES
I.
Purpose
Skipwith United Methodist Church seeks to establish reasonable procedures
to reduce the risk of physical, emotional and sexual abuse of children and as
they participate in church ministries, and to protect staff and volunteers from
false allegations of misconduct.
II.
Biblical Foundation
Skipwith United Methodist Church seeks to express God’s love of young
persons and to provide for their personal wholeness. This faith community
seeks to provide an environment which is caring and secure for all persons.
The Bible is foundational to our understanding upon which all policies,
procedures and ministries must stand.
Jesus teaches us explicitly that young persons have the right and the keys to
the Kingdom of God. He demonstrated this through blessing and touch.
Our goal in response to this Biblical mandate is, to the extent possible, to
maintain a safe, secure and loving place where children may grow.
As Christian adults, we want to help create and maintain a nurturing, loving,
safe and secure Christian environment, providing support and assistance to
our children, youth, and at-risk adults, remembering that our mandate is not
only a responsibility, but an opportunity to protect the gift that God has
bestowed upon us.
III.
Commonwealth of Virginia Statutes
Under Section 63.2-100 of the Code of Virginia, an abused child is defined
as one who is less than eighteen years of age,
1. Whose parents or other person responsible for his care creates or
inflicts, threatens to create or inflict, or allows to be created or
inflicted upon such child a physical or mental injury by other than
accidental means, or creates a substantial risk of death,
disfigurement, or impairment of bodily or mental functions,
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including but not limited to, a child who is with his parent or other
person responsible for his care either (i) during the manufacture or
attempted manufacture of a Schedule I or II controlled substance,
or (ii) during the unlawful sale of such substance by that child's
parents or other person responsible for his care, where such
manufacture, or attempted manufacture or unlawful sale would
constitute a felony violation of § 18.2-248;
2. Whose parents or other person responsible for his care neglects
or refuses to provide care necessary for his health. However, no
child who in good faith is under treatment solely by spiritual
means through prayer in accordance with the tenets and practices
of a recognized church or religious denomination shall for that
reason alone be considered to be an abused or neglected child;
3. Whose parents or other person responsible for his care abandons
such child;
4. Whose parents or other person responsible for his care commits
or allows to be committed any act of sexual exploitation or any
sexual act upon a child in violation of the law;
5. Who is without parental care or guardianship caused by the
unreasonable absence or the mental or physical incapacity of the
child's parent, guardian, legal custodian or other person standing in
loco parentis; or
6. Whose parents or other person responsible for his care creates a
substantial risk of physical or mental injury by knowingly leaving
the child alone in the same dwelling, including an apartment as
defined in § 55-79.2, with a person to whom the child is not related
by blood or marriage and who the parent or other person
responsible for his care knows has been convicted of an offense
against a minor for which registration is required as a violent
sexual offender pursuant to § 9.1-902.
An act of child abuse may be committed by any person responsible for the
care of another individual who is less than eighteen years of age. It does not
matter whether the person caring for the child under the age of 18
(hereinafter referred to as a "Child" or "Children", which term as used in this
Policy also includes youth ages 12-18) is a compensated or a volunteer
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worker. It does not matter whether the person routinely is entrusted with the
care of children or whether such individual only occasionally comes in
contact with children. It does not matter whether the person was entrusted
with the care of a child for an hour or only a moment. It only matters that a
child was abused or neglected by the person who, on the occasion in
question, was responsible for the child's care.
IV.
Types of Child Abuse
Definition
Child abuse refers to an act committed by a parent, care giver or person in a
position of trust (even though he/she may not care for the child on a daily
basis) which is not accidental and which harms or threatens to harm a child’s
physical or mental health or welfare. The following definitions and
explanations in this section are from the Virginia Department of Social
Services.
B. Types of Abuse
1. Physical Abuse
A physical injury, threat of injury or creation of a real and significant danger
of substantial risk of death, disfigurement or impairment of bodily functions.
Such injury or threat of injury, regardless of intent, is inflicted or allowed to
be inflicted by non-accidental means. Examples: asphyxiation; bone
fracture; brain damage, skull fracture, subdural hematoma; burns, scalding;
cuts, bruises, welts, abrasions; internal injuries, poisoning; sprains;
dislocations; gunshot, stabbing wounds.
2. Physical Neglect
The failure to provide food, clothing, shelter, or supervision for a child if the
child’s health or safety is endangered. Physical neglect may include
multiple occurrences or a one-time critical or severe event that results in a
threat to health or safety, such as a toddler left alone. Other types of neglect
include abandonment, inadequate supervision, inadequate clothing,
inadequate shelter, inadequate personal hygiene, inadequate food and
malnutrition.
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Approved November 9, 2014 by Leadership Council
3. Sexual Abuse
Sexual abuse includes any act defined in the code of Virginia which is
committed, or allowed to be committed, upon a child by his/her parent or
other persons responsible for the child’s care. Examples of such abuse are:
sexual exploitation, sexual molestation, intercourse/sodomy and other sexual
abuse.
4. Medical Neglect
Refusal or failure by caretaker to obtain and/or follow through with a
complete regimen of medical, mental or dental care for a condition, which if
untreated, could result in illness or developmental delays.
5. Failure to Thrive
A syndrome of infancy or early childhood which is characterized by growth
failure, signs of severe malnutrition, and variable degrees of developmental
retardation. Children are considered to be in this category only when the
syndrome is diagnosed by a physician and is caused by non-organic factors.
6. Mental Abuse/Neglect
A pattern of acts or omissions by the caretaker which result in harm to a
child’s psychological or emotional health or development.
7. Educational Neglect
The child’s caretaker is directly responsible for the failure of the child to
attend school or an approved alternative program of study.
8. Bizarre Discipline
Any actions in which the caretaker uses eccentric, irrational or grossly
inappropriate procedures or devices to modify the child’s behavior.
V.
Reducing the Risk of Child Abuse
In an effort to create a safe environment within Skipwith United Methodist
Church, several abuse prevention measures will be utilized. These measures
include screening of paid and volunteer workers for past child abuse
convictions or expungements, provision for regular training on child abuse
issues to paid and volunteer staff members, use of the two leader/adult rule,
standards of appropriate classroom discipline and open classrooms.
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Approved November 9, 2014 by Leadership Council
1. Six Month Rule
Skipwith United Methodist Church will not use anyone as a leader, with the
exception of paid staff, for children or youth ministries in the church unless
such person has had continuous active involvement (attending/participating)
in the church for at least six (6) months.
2. Staff/Volunteer Screening
Before beginning their first year of service and thereafter annually, each
employed or volunteer leader for children or youth ministries including short
term volunteers, children or youth teachers, child care workers (nursery) or
youth workers will be asked to complete a background check through the
National Sex Offender Registry at http://www.nsopw.gov or other
appropriate agency. Anyone who is found to have a record through this
registry will not be permitted to work with children/youth. Within three
months of the adoption of this policy, all existing workers with children and
youth will comply with this paragraph in order to continue in their positions.
The church office will maintain these records in a safe and confidential file.
3. Staff Training
Before beginning their first year of service, all paid and volunteer leaders,
child care workers, children and youth Sunday School teachers and youth
workers will be required to read the church’s child protection policy and
sign a form indicating that they have read and that they understand the
policy and agree to abide by it. Anyone failing to do so will not be
permitted to serve until the policy has been read and the form signed.
Teachers or workers with youth and children will be required to attend one
training session related to the church’s child protection policy offered by the
church or related organization. Any short term volunteers who have not
attended the training should always be in the company of a long term
volunteer who has attended the training.
Leaders of community groups who use the church facility are required to
read the policy and sign the acknowledgment form. Church facilities will
not be available to groups whose leaders refuse to read and sign the policy.
Vacation Bible School teachers/workers (18 years old and older) at Skipwith
United Methodist Church will be required to read the policy and sign the
acknowledgment form before the start of Vacation Bible School when
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Approved November 9, 2014 by Leadership Council
Skipwith is the host church. Anyone refusing to read the policy and sign the
form will not be permitted to serve.
4. Two Adult Rule
Whenever possible, leaders and child care and youth workers will be
assigned in teams of two or more for all children or youth activities. These
two leaders will be adults age 18 or older and at least 5 years older than the
children and youth they are with. If there are not two leaders available for
each group, then the activity will be conducted with open doors to the
meeting room. Youth helpers, under age 18, will not be considered as one of
the two adults.
Community groups of children or youth who meet at the church should,
whenever possible, have two or more leaders present who have read these
rules and signed the attached form . If any group stays overnight at the
church, or if a church sponsored group leaves the premises, two or more
leaders must be present and whenever possible, include at least one male and
one female not related by marriage, if the group is mixed in gender.
5. Adequate Supervision
We aim to provide adequate supervision at all times:
- One adult to three children, zero to twelve months of age.
- One adult to four children, ages twelve to twenty-four months
- One adult to six children, ages twenty-four months to thirty-six months
- One adult to eight children, ages three to eighteen years
The specific needs of individual children may require a change to these
guidelines.
6. One-on-One Mentoring or Consultation
Any one-on-one mentoring or consultation between an adult and a child will
be conducted in a room or area that is in plain view of others.
7. Classroom Discipline
All leaders and workers with children and youth will use the following
discipline measures. If a child is behaving inappropriately, the leader or
worker will tell the child specifically what he/she is doing that is not
acceptable and state what the expected behavior is, e.g., “We do not throw
blocks. We use blocks for building.” If this measure is not effective, the
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child will be guided to another activity. If inappropriate behavior continues,
the child may be placed at a table to work alone away from the other
students. If the child’s disruptive behavior continues after these steps have
been taken, the child may be taken to the primary leader for the activity and
left under his or her supervision. No physical punishment or verbal abuse,
e.g., ridicule, are to be used at any time. If isolating the child within the
classroom or removal of the child from the room becomes necessary, the
situation will be discussed with the child’s parents or guardian as soon as
possible.
8. Open Classrooms
Classrooms or child care rooms may be visited without prior notice by
church staff, parents, or other volunteer church workers, e.g., Sunday School
Superintendent, Education Committee Chair, at any time. Brief observations
of child care rooms and classrooms of children or youth are conducted by
the pastor or the primary leader during all activities.
9. Child Protection Committee
The Board of Trustees of Skipwth United Methodist Church may appoint a
Child Protection Committee to include the pastor and not less than three nor
more than five members of the church. If established, the Child Protection
Committee shall review and propose any revisions to this Policy as needed,
and shall be responsible for the administration and interpretations of this
Policy.
VI.
Reporting Child Abuse
If there is an allegation of child abuse at Skipwith United Methodist Church,
the following procedures shall be followed:
1. Any allegation of child abuse shall be treated seriously.
2. Pray for the church and all persons affected by the allegation.
3. Immediately begin documenting all procedures which occur in handling
the allegation.
4. Immediately notify the pastor and, if applicable, a member of the Child
Protection Committee, of the substance of the allegations, unless the
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Approved November 9, 2014 by Leadership Council
allegations involve the pastor. Any person notified shall immediately
contact the pastor. If there is a Committee, the function of the Committee
will be to determine, based upon the allegations and the information then in
the possession of the Committee, the next steps. In making such a
determination, the Committee shall avail itself of such counsel as it deems
necessary and as is immediately available, including, but not limited to,
consultation with an attorney, with a representative of the church’s insurance
company, with the district superintendent, and anonymously with the
Virginia Department of Social Services.
If the allegations involve the pastor, the Chairperson of the Staff-Parish
Committee shall be notified immediately and he or she shall immediately
notify the district superintendent who shall direct the next steps taken by the
church in responding to the allegations. The provisions of this Policy shall
continue to apply except as the district superintendent directs that other steps
be taken.
5. Depending on what the Pastor or Child Protection Committee determines,
then the following steps may be taken:
a. Immediately notify the Virginia Department of Social Services of the
allegation.
b. Immediately notify the parents if it is not known that they have
previous knowledge.
c. Immediately notify the church’s insurance company.
d. Immediately notify the district superintendent.
6. Do not confront the accused with the allegation. If the accused has
assigned duties within the life of the church and the Pastor or Child
Protection Committee, if any, determines that the steps outlined in paragraph
VI (5) above are appropriate, that person must be temporarily relieved of
their duties until the investigation is concluded.
7. The pastor should extend whatever care and resources are necessary to
those impacted by the allegation, but under no circumstances should the
pastor or any church leader or member investigate the allegation. In
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providing care to the principals (alleged victim and the accused) and their
families, the pastor or church leader, should under no circumstances be
drawn into a discussion of the truth or falsity of the allegation which could
contaminate the investigation. Do not assign blame or take any steps that
involve establishing or refuting the allegation.
8. It is appropriate to show care and comfort for the alleged victim. This
should be the pastoral objective from the moment the allegation is received
or otherwise made known.
9. Observe confidentiality for both the alleged victim and the accused to the
extent possible.
10. There shall be a single spokesperson for the Church who shall be
designated by the Pastor or the Child Protection Committee, if any.
VII. Policy Review
The Child Protection Policy and Procedures of Skipwith United Methodist
Church shall be reviewed annually by the Board of Trustees or its designee.
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After reviewing the foregoing Policy and Procedures, please sign, date, detach and
return this page to indicate that you have read, understood and accept the Child
Protection Policy and Procedures of Skipwith United Methodist Church.
Name
Address ___ ______________________________________________
City _______________
_State _______ Zip ___ _____
Phone Number(s)____________________________________________________
Name/s of church/es you have attended regularly during the past five years:
______________________________________________________________
List all previous non-church work involving children or youth (names/addresses):
_______________________________________________________________
List your current driver’s license number_______________________________
Personal References (Not former employers or relatives)
Name_________________________ Telephone________________________
Name_________________________ Telephone________________________
I have read and understand the Child Protection Policy and Procedures of Skipwith
United Methodist Church. I agree to abide by those policies and procedures. I
have no convictions for child abuse or expungements of such convictions. I
authorize and release any references or churches to provide to Skipwith United
Methodist Church any information (including opinions) that they may have
regarding my work with children and/or youth.
_______
Signature
Date
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Approved November 9, 2014 by Leadership Council