Teen Background Check Form | McConnell Memorial Baptist Church

CPT for Teens under 18

This application is to be completed for any position (paid or volunteer) involving the supervision or care of minors or the mentally handicapped. This is being used to provide a safe and secure environment for the activities or programs of the church.

Step 1 of 3

Name(Required)

First Middle Last

Your Phone for Texting

Date of Birth(Required)

Age

School you Attend

Grade

Address where you live(Required)

Street Address City State ZIP Code

Teen Signature(Required)

I understand that in serving as a volunteer or in a paid position for the McConnell Memorial Baptist Church that I am willing to abide by the Policies & Procedures set forth in the Child Protection Program to reduce the risk of Child Abuse in this church. I understand that child abuse is a serious matter and will do my part in its prevention while serving.

Date(Required)

Parent/Guardian Name(Required)

First Last

Parent's Email(Required)

Enter Email Confirm Email

Parent's Phone Number(Required)

SPONSOR/VOLUNTEER CODE OF ETHICS AND RULES(Required)

I understand that any violation of this code may be grounds for removal as a sponsor or volunteer with children.

While acting in your capacity as a Youth/Children/Preschool/Handicapped sponsor or volunteer of
McConnell Memorial Baptist Church, the following rules shall apply:

Sponsors and volunteers of minors agree to . . .
◊ Be free of physical and psychological conditions that might adversely affect any minor’s health,
including, but not limited to, contagious disease (that you are aware of).
◊ Exemplify a positive role model for minors by maintaining an attitude of respect, loyalty,
patience, courtesy, and maturity.
◊ Take every reasonable precaution to avoid being put in a situation where you are alone with a
minor other than their own.
◊ Act and react with Christian love and understanding in all situations.
◊ Treat all people of all races, religions, and cultures with respect and consideration.
◊ When requested, update Volunteer Information Forms.

Refrain from . . .
◊ Smoking or using tobacco products on the McConnell Baptist Church campus.
◊ Using, possessing, or being under the influence of alcohol, illegal, or illicit drugs.
◊ The use of profanity.
◊ Any sexual activity in the presence of or in association with a minor; demonstration of sexual
activity, abuse, insinuation of abuse, or evidence of abusive conduct.

Immediately report to supervision any observation or suspicion of . . .
◊ Sexual advances or sexual activity of any kind between any person.
◊ Infliction or physically abusive behavior or bodily injury.
◊ Physical neglect of a child, including failure to provide adequate supervision, in relation to
the activities of McConnell Baptist Church.
◊ Mental or emotional injury to any individual.
◊ The presence or possession of obscene or pornographic materials at any function of McConnell
Baptist Church.
◊ The presence, possession, or being under the influence of any illegal, illicit drugs
◊ The consumption of, or being under the influence of, alcohol while leading or participating in a
function of McConnell Baptist Church.