Safe Sanctuaries Policy First United Methodist Church, Washington, NC

Table of Contents

Section Page #

1. Introduction and Statements of Covenant, Purpose and Scope 2

2. Definitions 3

3. Screening 4

4. Training 5

5. Risk Management 5

6. Responsibilities 8

7. Reporting and Response 8

8. Public Response Plan 9

9. Authorization 9

Appendix 1 – Parent/Guardian Consent Form 10

Appendix 2 – Confidential Screening Form 11

Appendix 3 – Form for Reference Check 14

Appendix 4 – Volunteer Worker Enlistment Checklist 15

Appendix 5 – Participation Covenant 16

Appendix 6 – Youth Volunteer Covenant 17

Appendix 7 – Outside Groups Covenant 18

Appendix 8 – Accident Report Form 19

Appendix 9 – Incident Report Form 20

1 Safe Sanctuaries Policy First United Methodist Church, Washington, NC

1. Introduction and Statements of Covenant, Purpose and Scope

1.1 Introduction The General Conference of the United Methodist Church, in April 1996 adopted a resolution aimed at reducing the risk of child sexual abuse in the church. The adopted resolution includes the following statement:

Jesus said, “Whoever welcomes [a] child … welcomes me.” (Matthew 18:5) Children are our present and our future, our hope, our teachers, our inspiration. They are full participants in the life of the church and the realm of God.

Tragically, churches have not always been safe places for children. Child sexual abuse, exploitation and ritual abuse occur in churches, large and small, urban and rural. The problem cuts across all economic, cultural and racial lines. It is real, and it appears to be increasing. Most annual conferences can cite specific incidents of child sexual abuse and exploitation in their churches. Virtually every congregation has among its members adult survivors of early sexual trauma. Such incidents are devastating to all who are involved: the child, the family, the local church and its leaders. Increasingly, churches are torn apart by the legal, emotional, and monetary consequences of litigation following allegations of abuse.

God calls us to make our churches safe places, protecting children and other vulnerable persons from sexual and other forms of abuse. God calls us to create communities of faith where children and adults grow safe and strong. (The Book of Resolutions of the United Methodist Church.)

In our own North Carolina Annual Conference, the Safe Sanctuaries resolution of 2005 required that all local churches develop comprehensive policies and procedures to reduce the risk of abuse of our children and youth. In accordance with this resolution and as part of our covenantal connection with all United Methodist Churches, the Church Council of First United Methodist Church, Washington, NC gave final approval to the Safe Sanctuaries Policy document on September 26, 2006. These policies are subject to an ongoing evaluation and review process through the Safe Sanctuaries Committee that reports to the Church Council.

Specific policies and procedures have been arrived at by a review of our situation as a congregation and implementation of the best practices to reduce the risk of abuse as recommended by Safe Sanctuaries for Children and Youth by Rev. Joy Melton (Copyright 2004 Discipleship Resources) and other sources such as Prevent Child Abuse NC and applicable child protection statutes found in the North Carolina General Statutes.

1.2 Statement of Covenant As a Christian community of faith and a United Methodist congregation, we are committed to conduct the ministry of the gospel in ways that assure the safety and spiritual growth of all our children, youth and vulnerable adults as well as all adults volunteers. We will follow reasonable safety measures in the selection and recruitment of workers and we will be responsible in overseeing our programs and events and in training our staff, so that they are able and equipped to minister to children in Jesus’ name. We will have a clearly defined procedure for reporting a suspected incident of abuse/neglect consistent with North Carolina state law.

1.3 Policy Purpose Our purpose for establishing this Safe Sanctuaries Policy and accompanying procedures is to demonstrate our total and unwavering commitment to the physical, emotional and spiritual safety of all our children, youth and vulnerable adults.

1.4 Scope This Safe Sanctuaries Policy and Procedures shall apply to all persons who have any direct or indirect contact with children, youth or vulnerable adults who participate in any activities or events sponsored by First United Methodist Church, or by other organizations or individuals which occur on church property.

2. Definitions Abuse - any non-accidental (or substantial risk of) injury or pattern of injuries to a child, youth, or vulnerable adult inflicted or allowed to be inflicted by a parent, guardian, caretaker, or custodian. Types of recognized abuse include: ● Emotional Abuse – Abuse in which a person exposes a child, youth, or vulnerable adult to spoken and/or unspoken violence or emotional cruelty.

● Exploitation – illegal or improper use of a child, youth, or vulnerable adult to create pornography or sexually explicit websites for another person’s profit or advantage.

● Neglect – Any serious disregard by any person for supervision, care, or discipline.

● Physical Abuse – Any non-accidental physical injury or injuries by any person to a child, youth, or vulnerable adult. Examples of physical abuse include, but are not limited to: beating, harmful restraint, use of a weapon or instrument, or actions that result in or could result in serious physical injury.

● Ritual Abuse – Abuse of any of the types listed here that is occurring in a regular, intentional and stylized way to a child, youth, or vulnerable adult by a person or persons entrusted with their care.

● Sexual Abuse – Any sexual behavior imposed on a child, youth, or vulnerable adult by another person. This involves a range of activities, including fondling or other inappropriate physical contact. It also includes exhibitionism, child pornography, and suggestive behavior or comments.

Adult - any person 18 years of age or older.

Child or youth - any person under the age of 18.

Children’s and youth activities - any activity or program in which children are under supervision of persons (staff or volunteers) in charge of these activities. “Children’s ministries” at First United Methodist Church include infant through fifth grade. “Youth ministries” include children in grades six through twelve.

Church or We – the congregation of First United Methodist Church.

Definitions of Various Volunteers  Approved Volunteer – serves an active or leadership role and has direct contact with children, youth, and vulnerable adults. Examples of approved volunteers are (but are not limited to) Sunday school teachers, UMYF/JAM leaders, VBS crew leaders, volunteers who drive the church van when children, youth, or vulnerable adults are present, and volunteers who visit homebound members of our congregation. 3 Safe Sanctuaries Policy First United Methodist Church, Washington, NC

 Volunteer – serves a support role, working on a one-time or occasional basis, and having little or no contact with children, youth, or vulnerable adults. They may help set up or decorate a room, attend a service, or otherwise participate in ministry for children, youth or vulnerable adults.  Youth Volunteer – youth under the age of 18 who assist in a support role in children’s and/or youth activities. Youth volunteers cannot be considered an adult volunteer and must be supervised by a staff person or Approved Volunteer.

Outside Group - any group that does not fall under the ministries or responsibility of First United Methodist Church. Examples include Washington Women’s Bible Study, Young Lives, Homeschool Group.

Persons required to report abuse - In accordance with North Carolina State Law, any person who observes or suspects an occurrence of abuse of a child, youth, or vulnerable adult is mandated to report it to the Department of Social Services.

Program Staff – a staff person employed by First United Methodist Church who is responsible for a particular ministry area. Examples include Youth Ministry, Adult Ministry, Music Ministry.

Safe Sanctuaries Committee – a committee comprised of the following: Senior Pastor, Representatives from Church Council, SPRC, Trustees, Preschool, Childcare, and Program Staff or laity elected at the Annual Charge Conference.

Staff person - any person employed and paid by First United Methodist Church. These persons also fall under the personnel policies adopted and implemented by the Staff Parish Relations Committee.

Vulnerable adult - any person over 18 years of age with diagnosed diminished physical, mental or emotional capacities, either for a temporary period or long term, who are unable to fully care for themselves.

3. Screening

3.1 All paid staff of the church must have a criminal background check and complete Safe Sanctuaries training.

3.2 Approved Volunteers serving with children, youth, or vulnerable adults must have completed the Volunteer Screening Form, Participation Covenant, Background Check and Safe Sanctuaries training. This type of volunteer must be at least 18 years old and at least 5 years older than the oldest child/youth participating in the activity. An Approved Volunteer must have been a regular attendee of First United Methodist Church services or activities for a minimum of 6 months.

3.3 Volunteers serving with children, youth, or vulnerable adults who have not yet met the requirements of the Approved Volunteer status will be required to complete the Confidential Screening form and work under the supervision of a staff person or Approved Volunteer.

3.4 Youth Volunteers serving with children, youth, or vulnerable adults must complete the Youth Volunteer Covenant, have parental consent, and be at least 5 years older than the oldest child/youth participating in the activity.

3.5 Routine background checks will be completed every 3 years for all staff and Approved Volunteers, cost to be covered by the church. Volunteers wishing to be an approved driver for children, youth, or vulnerable adults must also submit their North Carolina Driver’s License number in order to obtain a complete driving record.

4. Training

4.1 Safe Sanctuaries and Abuse Awareness Training – All new staff and Approved Volunteers working with children, youth, or vulnerable adults will be required to participate in a comprehensive Safe Sanctuaries training event which will include recognizing abuse, who abusers are and what we are doing to keep our children, youth and vulnerable adults safe, including screening, training and reporting of suspected abuse. In addition, staff and volunteers will be trained how to detect if a child is suspected to be subjected to abuse at home and what action should be taken. At the conclusion of the training, participants will sign a Participation Covenant Statement. Additional training may be available throughout the year for new staff and volunteers as necessary.

4.2 Continued Training – All current staff and Approved Volunteers will participate in annual Safe Sanctuaries training to update their knowledge of policies and procedures. This training will also include signing a new Participation Covenant Statement. Notices of any substantial changes in the law or policy will be communicated as soon as possible.

4.3 First Aid/CPR Training – All paid nursery workers, preschool staff, childcare center staff, clergy and program staff are required to be certified in First Aid/CPR, cost to be covered by the church. CPR/First Aid Training is strongly encouraged for all Approved Volunteers and Youth Volunteers, cost to be covered by the church.

God calls us to make our churches safe places, protecting children and other vulnerable persons from sexual and ritual abuse. God calls us to create communities of faith where children and adults grow safe and strong. (From The Book of Resolutions of The United Methodist Church – 200, pp. 180-181.)

The North Carolina Annual Conference in June, 2005 passed a resolution directing “each and every local church to adopt and implement for themselves a safe sanctuary policy and procedures as outlined in the 1996 General Conference Resolution (Book of Resolutions of the United Methodist Church, 1996, pp. 384-386) for use in their present and future ministry with children and youth.”

In accordance with these resolutions and as part of our covenantal connection with all United Methodist Churches, a Safe Sanctuaries Task Force was formed by the Church Council of First United Methodist Church, Washington, NC. Some members of that task force attended a training event in September 2005 offered by the Greenville District using the resource book Safe Sanctuaries for Youth Ministry by Joy Melton (Discipleship Resources). The Task Force began meeting regularly starting in October of 2005 using material from the training session and other sources as a guide. This document was given final approval by the Church Council of First United Methodist Church, Washington, NC. on September 26, 2006 and became the official policy of the church.

This policy reflects our congregation’s mission statement “Knowing Christ; Growing in Christ; Sharing in Christ;” in the following ways:

5 Safe Sanctuaries Policy First United Methodist Church, Washington, NC Knowing Christ and his concern for children is our theological basis. To quote Matthew 18:5-6, “And whoever welcomes a little child like this in my name welcomes me. But if anyone causes one of these little ones who believe in me to sin, it would be better for him to have a large millstone hung around his neck and be drowned in the depths of the sea.” Growing in Christ by demonstrating our commitment to providing the best environment for young people to grow in their relationship to Christ.

6 Safe Sanctuaries Policy First United Methodist Church, Washington, NC Sharing Christ in the most responsible and safest ways possible.BASIC PROCEDUR5. Risk Management

5.1 Crime of Abuse Rule – Persons who are deemed a threat to children, youth or vulnerable adults based on a criminal record check, application response, or reference feedback will not be permitted to volunteer, be employed, or be accepted as a volunteer or paid worker in any church-sponsored program for children, youth, or vulnerable adults.

5.2 Six Month Rule – All Approved Volunteers must be either a regular attendee or member of FUMC for at least 6 months before they are allowed to serve in an active or leadership role with children, youth, or vulnerable adults. There shall be an exception for parents of children/youth who may volunteer to serve as a regular volunteer immediately upon becoming church members and completing a background check and Safe Sanctuaries training. Any other exceptions must be approved by the Senior Pastor.

5.3 Two Adult Rule – A minimum of two adult volunteers (one of which must be a staff person or Approved Volunteer) should be present in each classroom, at each activity and in every interaction with children, youth, or vulnerable adults. If that is not possible, a staff person or Approved Volunteer will be on site to monitor classes and activities where only one adult is present.

5.4 Spouses Working Together – If the two adult volunteers working together are spouses or related, a staff person or Approved Volunteer will monitor the classroom and transportation.

5.5 Monitoring and Visibility – All classrooms and other areas of the building will be monitored while activities for children, youth, or vulnerable adults are ongoing. All classroom and office doors will have glass panels or other provision for visibility and accountability. The glass panel must not be covered and should allow vision of all spaces within the classroom area. If an activity is held in any room that does not have a glass panel in the door or half-door, the door must remain fully open at all time.

5.6 Counseling – At any one-on-one counseling sessions with children, youth, or vulnerable adults, the doors used on the room must remain open for the entire session, ideally when others are nearby, even though not in listening distance.

5.7 Open Classrooms – Classrooms or childcare rooms may be visited without prior notice by church staff, directors of the individual programs and parents.

5.8 Parental Permission – Children and youth should have parental permission for involvement in church- sponsored activities and programs. Parents must be informed and permission granted in writing prior to their child or youth participating in any event or any discussion deemed to be of a controversial nature.

5.9 Buddy System – We encourage the parents, teachers and leaders of anyone under the age of 18 to make sure the children/youth always have a “buddy” who is close to their age, so that no child is ever alone while in the church buildings, or while on an activity, trip, or overnight.

5.10 Discipline Procedures for Children and Youth – All staff and volunteers will deal with children and youth in a positive and respectful manner when behavior problems occur. Striking, spanking or any other manner of physical discipline is prohibited. Verbal abuse, along with other forms of abuse, is also prohibited.

7 Safe Sanctuaries Policy First United Methodist Church, Washington, NC 5.11 Diaper Changing – Two Adult rule applies. Changing diapers should be done within view of another staff member or Approved Volunteer.

5.12 Restrooms – When children/youth are participating in activities on church property, it is recommended that the restroom doors remain propped open. Only a staff member or Approved Volunteer should enter the stall/restroom to aid the child and the door should never be locked. Youth Volunteers are not permitted to take children to the restroom.

5.13 First Aid Kits – The church will provide and maintain first aid kits. These first aid kits will be inspected and maintained at regular intervals by the custodial staff. Locations of first aid kits will be posted so they will be easy to find in case of an emergency.

5.14 Overnight Activities and Trips – Two Adult rule applies. Two staff members or Approved Volunteers shall be present throughout any overnight activity or trip. If the group is of mixed gender, the leaders must include at least one male and one female, not married. Youth will not share a bed with an adult. A minimum of three persons shall be assigned to a room, if possible. Males and females should be housed in separate rooms, with the exception of married couples. There will be no visiting between bedrooms unless directly supervised in a group setting with the counselors for a devotional or group discussion time.

5.15 Transportation  All vehicle operators driving children/youth must be staff members or Approved Volunteers who are at least 25 years old and who have not been convicted of DWI or drug-related charges within the last seven years.

 Youth are not permitted to drive for youth events outside the Washington/Greenville area. If a parent wishes to give permission for their youth to drive to a short-term event in the Washington/Greenville area, they must sign a waiver. But under no circumstances may a youth transport another youth unless they are a sibling. If a youth is given permission to join a youth overnight trip, a parent is responsible for transporting the youth to the site.  Compliance with North Carolina law in regards to seat belts, car seats and front passenger airbags is required.

5.16 Electronic Communication and Social Media Policy – Two Adult rule applies. No child/youth shall be contacted by a staff member or volunteer without copying at least one other unrelated adult staff member or Approved Volunteer on the communication. This applies to all forms of social media and electronic contact including but not limited to Facebook, Twitter, Instagram, email, and any other similar communication method. Snapchat interaction is prohibited. In addition:  Staff members/volunteers should not initiate Facebook contact with or “friend” a minor or vulnerable adult. A staff person/volunteer accepting the “friend” request of minors/vulnerable adults is up to the discretion of the staff person/volunteer.  When checking in on Facebook, Foursquare or any location tagging social media, only “check in” yourself. Never check in minors.  Texting, while not subject to the “Two Adult Rule” above, should be limited to youth/children’s ministries related communications and correspondence.

5.17 Physical contact with children/youth – Staff and volunteers should demonstrate appropriate affection to all children/youth.

 The following forms of affection are regarded as appropriate examples: side hugs; hand shakes; high fives; verbal praise; kneeling or bending down for hugs with youth children; holding hands during prayers.  Inappropriate forms of affection should be avoided and include: lengthy embraces; kisses; holding a child (K-5th grade) or youth on your lap; touching bottoms, chests or genital areas; showing affection in isolated areas; any type of massage; any form of unwanted affection; and compliments that related to physique or body development.

5.18 Use of Alcohol and Other Substances that Impair Cognitive Faculties – At no time will staff or volunteers be allowed to supervise or work with children, youth or vulnerable adults while under the influence of alcohol or other substances that would impair cognitive faculties. If a staff member or volunteer is using medicine that causes such impairment, the volunteer will not be assigned any duties during such time as the drug is in use.

5.19 Weapons – At no time will staff or volunteers be allowed to supervise or work with children, youth or vulnerable adults while carrying a weapon (open carry or concealed).

5.20 Vacation Bible School – VBS requires numerous volunteers for just one week out of the year. Great effort will be given to involve as many staff and Approved Volunteers as possible, spreading these leaders out so that at least one is in each class or grouping. In addition, a one-time orientation or training for VBS helpers will be provided prior to the week of VBS. As a part of this training, a segment will be devoted to Safe Sanctuaries overall safety guidelines.

5.21 Preschool/Childcare Center Security Policies – The Preschool Program and licensed Childcare Center must have detailed, program specific, employee handbooks and security policies that are conscientiously followed. All teachers shall abide by the program specific security policies and employee handbooks as well as this Safe Sanctuaries Policy. In lieu of the “Two Adult Rule” the programs shall meet or exceed the North Carolina Division of Child Development and Early Education’s child/staff ratios at all times.

5.22 Boy Scout Troop 99 – Adult leaders registered in the Boy Scouts of America are exempt from requirements for background checks and policies concerning adult leader selection and behavior, as these procedures are already in place and operational at the national level. All such individuals must abide by said national policies, including those pertaining to youth protection.

5.23 Outside Groups – Organizations and individuals requesting use of church facilities for private functions involving children/youth/vulnerable adults will be provided with a copy of this policy and required to sign an Outside Groups Covenant and abide by its requirements. If the signing representative changes, this must be reported within 10 days and a new representative must sign the form. If an outside group wants to use the facilities for a one-time event and does not want to comply with the requirements of the Safe Sanctuaries Policy, the group may hire Safe Sanctuary approved workers from First United Methodist Church.

6. Responsibilities

6.1 Safe Sanctuaries Committee – is responsible for:  Approving procedures within the scope of this policy, initially and reviewing this policy at least annually in August thereafter;

9 Safe Sanctuaries Policy First United Methodist Church, Washington, NC  Implementing the provisions of this policy with regard to annual training;  In conjunction with staff, communicating key principals of the Safe Sanctuaries Policy to the congregation at large;  Processing volunteer screening forms and recording that the volunteer has completed the Volunteer Screening form, background check, Participation Covenant, and Safe Sanctuaries training.

6.2 SPRC - is responsible for making sure all paid staff of the church has criminal background checks, reference checks, are First Aid/CPR certified, and have completed Safe Sanctuaries training.

6.3 Board of Trustees – is responsible for reviewing this policy with the insurance company and for assuring that, in the event of litigation pertaining to an incident of abuse, insurance is sufficient to protect the people and assets of First United Methodist Church. The trustees will assure that outside groups using the facilities of First United Methodist Church, are given a copy of this policy, and sign an Outside Groups Covenant. All relevant paperwork will be secured in the church office files.

7. Reporting and Response

7.1 Accidents – When an accident occurs, the leader (staff or volunteer) will immediately address any needs the child, youth or vulnerable adult may have, medical or otherwise, and contact 911 as deemed necessary. A member of the Pastoral Staff and the child/youth’s parents should be notified as soon as possible. Once the situation has been resolved, the leader will complete an Accident Report Form (see appendices), which will be shared with the Safe Sanctuaries Committee. All information pertaining to Accident Reports will be collected and maintained by the Church Office Administrator for at least one-year duration from the date of the Accident Report.

7.2 Suspected Incident of Abuse – Under North Carolina law, any person or institution that has cause to suspect that a child, youth, or vulnerable adult is being abused or neglected is required to report it. Reporting of suspected abuse/neglect is the first important step in stopping the abuse/neglect and protecting the child, youth or vulnerable adult from future harm. Any suspected abuse must be documented, reported immediately and kept strictly confidential.

 Any emergency needs of the victim must be addressed immediately and 911 contacted as deemed necessary.  The person suspected of the abuse must be removed from contact with the victim and from leadership during the impending investigation.  Reports of suspected abuse/neglect should be made as soon as possible to the Pastor, Event Leader, SPRC, DSS and the proper law enforcement agency.  The parent(s)/guardian(s) of the victim will be notified and steps will be taken to insure the victim’s safety until the parent(s)/guardian(s) arrive.  Supportive care will be given to all persons involved to include the victim of the suspected abuse (and his/her family) and the person suspected of the abuse (and his/her family) to restore all persons to wholeness. Supportive care can include the procedures of the criminal justice system, provisions of the Methodist Book of Discipline, appropriate counseling referrals and continued pastoral visitation.  The Pastor or Event Leader to whom the incident has been reported must immediately complete the incident report with all available details. Report forms will be kept in the church office. The District Superintendent must be notified within 24 yours. It will then be the decision of the District Superintendent, Pastor and other persons listed above as to the appropriate action to be taken. The District Superintendent will have final local authority in the matter. 10 Safe Sanctuaries Policy First United Methodist Church, Washington, NC

8. Public Response Plan

The Pastor or a designated spokesperson will handle dissemination of information to staff persons, media and congregation after consulting with appropriate authorities. No one else will be authorized to speak or give out any information concerning a case of alleged abuse. A clear position statement of the church’s policy and procedures to safeguard child, youth and vulnerable adults will be ready for release. At all times the privacy and confidentiality of all persons involved will be strictly maintained.

9. Authorization

This policy is authorized by the First United Methodist Church Council as indicated below and replaces the Original Safe Sanctuaries Policy approved on September 26, 2006.

______Date Patty Peebles, Chairperson Church Council

Appendix 1

Parent/Guardian Consent Form

This Parent Consent Form gives permission for my child to participate in an activity off campus and sponsored by FUMC. (All portions of this form shall be completed before the child is registered for the event).

Name of CHILD: ______Home Phone #: ______

Name of PARENT: ______Cell Phone #: ______

Address: ______

I give permission for my child ______to attend and participate in ______(Full name of child) ______including those that require off-campus transportation. (insert name of event)

My child has the following physical condition that may require special attention: □ Diabetes □ Hyperventilation □ Convulsions □ Seizures □ Allergies

Please specify allergies: ______

□ Other (please specify): ______11 Safe Sanctuaries Policy First United Methodist Church, Washington, NC

Does your child require any special accommodations or have special accessibility needs? ______

If yes, please explain ______(A Ministry Leader will contact you to discuss these needs.)

Medical Treatment Release, Liability Release, and Photograph Release

I hereby authorize event staff to obtain and give consent for medical treatment for my child for such injury or illness that may occur during the event and hereby hold the event staff and their representatives harmless in the exercise of this authority.

I give permission for my child to be transported in vehicles operated by the adults in whose care the minor has been entrusted while attending and participating in this event.

It is my understanding that the above named participant will be covered by my personal medical insurance. The event provides limited/supplemental medical payment coverage for injuries arising out of the event activities which is payable in excess of any other collectible insurance. Payments of any medical injuries not covered by my insurance or the event limited/supplemental medical insurance will be paid by me.

I give permission for photographs of my child taken during the trip to be used at the discretion of FUMC and the Children’s Ministries leadership wherever deemed appropriate.

Name of parent/guardian: ______Signature of parent/guardian: ______(please print)

Date: ______Medical Insurance Carrier: ______Group #: ______

(Attach Copy of both sides of the Insurance Card)

Appendix 2

CONFIDENTIAL SCREENING FORM FOR EMPLOYEES & VOLUNTEERS WORKING WITH MINORS FIRST UNITED METHODIST CHURCH OF WASHINGTON, NC

This form will be reviewed by the Senior Pastor and the Minister of Children and Youth. Please answer each question candidly and completely. This form will be kept in a confidential file to protect your privacy. The results of the background check will be seen only by the Senior Pastor and kept in a locked box to protect your privacy.

Date: ______

FULL AND COMPLETE NAME. Please include maiden name, all married names and nicknames that you commonly are known by such as “Trip, Sonny, etc.”. Please print!

______

Date of birth______

12 Safe Sanctuaries Policy First United Methodist Church, Washington, NC Address: ______

Daytime phone: ______Evening phone: ______

Occupation: ______

Employer: ______

Employer’s Address: ______

Current job responsibilities and schedule:

Previous work experience:

How many hours per week are you available to work/volunteer? ______

_____ daytime _____ evenings _____ weekends

Can you make a one-year commitment to this volunteer role? Why would you like to volunteer as a worker with children or youth?

What qualities do you have that would help you work with youth?

Would you be available for periodic volunteer training sessions? _____ No _____ Yes

Is there any additional training for volunteers that you think would be helpful?

List any churches besides First UMC, Washington you have attended regularly in the last 5 years:

Church & address type of volunteer work dates

List all other volunteer work and employment involving children/youth

Organization type of volunteer work dates

Do you have your own transportation? _____ No _____ Yes

Do you have a valid driver’s license? _____ No _____ Yes

Do you have liability insurance? (list name of carrier)

Two references (Do not list relatives)

1. Name:

Address:

Daytime phone: Evening Phone:

Relationship to reference:

2. Name:

Address:

Daytime phone: Evening Phone:

Relationship to reference:

Please circle “yes” or “no”. If you answer “yes” to any of the following questions, please attach an explanation noting the date, nature and place of the incident involved or necessary details regarding medical conditions. A “yes” answer will not necessarily disqualify a person from serving as a volunteer.

1. Have you ever lived outside the state of North Carolina? If so, list other states and/or countries and dates in residence. Yes / No

2. Have you ever had your employment or volunteer position terminated for any reason? If yes, give reason. Yes / No

3. Are you willing to provide transportation for children or youth? Yes / No

If yes circle one of the below and answer the next four questions.

Prefer only my own vehicle Prefer rented vehicle No preference, will drive either

a. Has your driver’s license ever been revoked or suspended? Yes / No

b. In the past three years, have you been convicted of, pleaded guilty to or received a “prayer for judgment”, any offense involving a moving vehicle violation in this state or any other state? 14 Safe Sanctuaries Policy First United Methodist Church, Washington, NC Yes / No

c. Do you have seizures of any kind? If so, are they controlled by medication? Yes / No

d. Do you regularly take any medication that could affect your ability to drive? Yes / No

Please fill out and sign the consent form for a background check. The information will be kept confidential!

CERTIFICATION The information provided herein and on the Confidential screening form is true and correct to the best of my knowledge. I authorize any organization listed herein to give you any information that they may have regarding my character and fitness to work with minors. I agree to be bound by the First United Methodist Church of Washington, NC “Safe Sanctuaries Policy” and have received a copy.

Signature & date: ______

Appendix 3

FORM FOR REFERENCE CHECK

Applicant name: ______

Reference name: ______

Reference address: ______

Reference phone: ______

1. What is your relationship to the applicant?

2. How long have you known the applicant?

3. How would you describe the applicant?

4. How would you describe the applicant’s ability to relate to children/youth?

5. How would you describe the applicant’s ability to relate to adults?

6. How would you describe the applicant’s leadership abilities? 15 Safe Sanctuaries Policy First United Methodist Church, Washington, NC

7. How would you feel about having the applicant with your child/youth?

8. Do you know of any characteristics that would negatively affect the applicant’s ability to work with children/youth? If so, please describe them.

9. Please list any other comments you would like to make.

Reference Inquiry completed by: ______Signature and date

Appendix 4

VOLUNTEER CHILD/YOUTH WORKER ENLISTMENT CHECKLIST

Task to complete Completed by – Initials & date

___ Church status verified (minimum 6 months involvement) ______

___ Application & screening forms completed ______

___ Signed background check consent form ______

___ Background check form sent to agency ______

___ Background check report received and reviewed by designated staff member ______

___ References checked ______

___ Copy of policies and procedures given to applicant ______

___ Applicant completes church training event ______

___ Copy of driver’s license on file (if needed) ______16 Safe Sanctuaries Policy First United Methodist Church, Washington, NC

___ Applicant informed of approval or disqualification ______

Appendix 5

Participation Covenant Statement (To be completed by all Approved Volunteers)

The congregation of First United Methodist Church, Washington is committed to providing a safe and secure environment for all children, tweens, youth, and adults who participate in ministries and activities sponsored by the church. The following statements reflect our congregation’s commitment to preserving this church as a holy place of safety and protection for all who would enter and as a place in which all people can experience the love of God through relationships with others.

Please answer the following questions:

1. As a member of FUMC do you agree to observe and abide by all church policies regarding working in ministries with children, youth, and vulnerable adults? Yes No

2. As a member of FUMC, do you agree to observe “The Two Adult Rule”? Yes No

3. As a member of FUMC, do you agree to participate in training and educational events provided by the church related to your ministry? Yes No

4. As a member of FUMC, do you agree to promptly report abusive or inappropriate behavior to the event leader? Yes No

5. I have read the FUMC Safe Sanctuaries Policy. I agree to abide by this policy and to partner with the church in providing a safe environment for our children/youth/vulnerable adults. Yes No

17 Safe Sanctuaries Policy First United Methodist Church, Washington, NC 6. I have read this Safe Sanctuaries Participation Covenant Statement and I agree to observe and abide by the policies set forth above.

Signature: ______Date:______

Appendix 6

Youth Covenant Statement

Jesus said, "Let the little children come to me, and do not hinder them, for the kingdom of heaven belongs to such as these." Matthew 19:14

Covenant: Where I am a volunteer for Children's Ministry, I am a representative of that Christian community and I am responsible for my actions.

I understand and agree to abide by the following guidelines:

1. I will not bring or use any illegal drugs, alcoholic beverages or tobacco.

2. My conduct and talk will be respectful of all persons. I will not use any profanity or obscene language.

3. I will obey FUMC staff and adult volunteers at all times.

4. I will dress appropriately.

5. I will use my cell phone for emergency situations only.

6. I agree to serve in the areas that I am asked to serve and with whom I am asked to serve.

7. I understand that friends who have not gone through the training process will not be permitted to volunteer.

8. Above all else, I will focus on serving the children at FUMC and model the Christian faith and relate to the children to facilitate their Faith Walk. I have read and do understand the Youth Volunteer Covenant. To the best of my ability, I agree to abide by it. Failure to abide will result in a 1st time warning and second time dismissal from the Volunteer Youth Team.

Signature of Youth ______Date ______

Print Name ______Address ______Grade ______Email ______Cell Phone ______Home Phone ______

Signature of Parent ______Date______

Appendix 7

Outside Groups Covenant

The Congregation of First United Methodist Church Washington is committed to providing a safe and secure environment for all children, youth and volunteer workers who participate in ministries and activities at the church. The Safe Sanctuaries policy reflects our congregation’s commitment to preserving this church as a holy place of safety and protection for all who would enter and as a place in which all people can experience the love of God through relationships with others.

I have read and understand the Safe Sanctuaries Policy of FUMC. I agree to abide by all parts of this policy and am aware that failure to do so may result in the loss of privileges for my group or organization to use the facilities.

I am personally accepting responsibility to convey, in both oral and written form, a copy of this Safe Sanctuaries Policy to all members of my group or organization.

I, as an authorized agent of the above named group or organization, agree to release, waive, hold harmless, discharge, defend and indemnify FUMC from any and all claims, actions, or losses, for bodily injury, abuse, sexual misconduct/sexual abuse by any person acting as a member of my group or organization, or person present on the premises by invitation of my group or organization.

I understand that my group or organization can hire Safe Sanctuary approved childcare workers from FUMC.

Name of Outside Group or Organization:______

Name of Contact Person/Authorized Agent for Group:______(please print full name) Signature of Contact Person for Group: ______

Today’s date: ______

Address: ______

Daytime phone: ______Evening phone: ______

Cell phone: ______

Appendix 8 Accident Report Form

19 Safe Sanctuaries Policy First United Methodist Church, Washington, NC Use this form to make a report of an accident that occurred to a child or youth while attending an FUMC sponsored activity.

Today’s Date:______

Date/Time of Accident:______

Location of Accident: ______

Name of child or youth injured:______

Name of child’s or youth’s parent or guardian:______

Date and time parents contacted about accident:______

Name of person(s) who witnessed the accident:

Name: ______Phone: ______

Describe accident:______

______

Condition of child or youth, including the nature and extent of the injury:______

______

First aid or other care provided after accident: ______

______

Signature of person making report:______Date: ____/____/______

Printed name of person making report: ______Appendix 9

Incident of Suspected Abuse Report Form

NAME OF SUBJECT CHILD OR YOUTH

20 Safe Sanctuaries Policy First United Methodist Church, Washington, NC Name: ______

Address: ______Zip: ______Age: _____ Date of Birth: ______

PARENT OR LEGAL GUARDIAN OF SUBJECT CHILD OR YOUTH

Name: ______

Address (if different): ______Telephones: W______; H ______; C ______

PERSON MAKING REPORT OF INCIDENT

Name: ______

Relationship to child or youth: ______

Address: ______Telephones: W______; H ______; C ______

Signature of person reporting incident ______Date____/____/______

SPECIFIC ALLEGATION(s)

When speaking with an alleged victim of abuse, be careful to use open-ended questions. Let the alleged victim tell of the incident using his or her own words. Use this space to provide information to describe or explain the circumstances surrounding the incident you are reporting. You may attach additional sheets if necessary. Include in this report the following information, together with all other information you reasonably believe to be relevant:

Name of the FUMC leader of the activity or event: ______

Date of incident: ______Time: ______Place: ______

Any statement made by the alleged victim: ______21 Safe Sanctuaries Policy First United Methodist Church, Washington, NC

Describe any injury to the alleged victim: ______

Any emergency response required? If so, please describe: ______

Names of any witnesses to the alleged abuse: ______

Statements made by witnesses: ______

Any statement made by the person(s) being reported as having committed the alleged incident: ______Any immediate action taken by person submitting this report as a result of the incident: ______

REPORTING THIS INCIDENT Date and time incident reported to Pastor or Event Leader: ______

22 Safe Sanctuaries Policy First United Methodist Church, Washington, NC Date and time of call to law enforcement agency, name of reporting member, name of officer spoken to and content of that conversation: ______Date and time of call to the Beaufort County Department of Social Services, name of reporting member, name of worker spoken to, content of that conversation: ______

Date and time reported to District Superintendent, name of reporting member, and content of that conversation: ______

Date and time reported to FUMCW liability insurance carrier and name of reporting member: ______