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St Paul’s UMC – Safe Sanctuaries Home Page
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Initial Safe Sanctuaries Application
Your Information
Full Legal Name
*
Other legal names
Check here is under age 18:
Yes
Email Address
*
Phone Number
Date of Birth
*
Street Address
Apartment, suite, etc
City
State/Province
ZIP / Postal Code
Church Affiliation
St Paul's UMC - Tulsa
Driver’s license number
Answer these questions
If the answer to any of these questions is YES, use the text area at the bottom to provide additional information.
1. Have you ever been charged, convicted of, or pled guilty to a crime (misdemeanor or felony) against children or other persons ?
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Yes
No
(including but not limited to drug‐related charges, child abuse, other crimes of violence, theft or motor vehicle violations)
2. Has your driver’s license ever been revoked or suspended?
Yes
No
3. Have you ever habitually abused alcohol or controlled substances?
Yes
No
Agreement and Digital Signature
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Church activities and programs offer a unique setting for ministry to and with children and youth. We acknowledge that a special covenant is created when parents entrust their children and youth to the care of leaders in these settings. We hold each child and youth as a person of immeasurable worth as a child of God. With this understanding, I agree to:
• Respect each child, youth and adult, acting in an appropriate and Christian manner with each person I come into contact;
• Attend training events and prepare myself in advance for the activities(s) where I will work; if unable to attend, I will complete whatever alternative training is offered by the church.
• Follow the directions of the activity leader and policies as outlined in the Safe Sanctuaries Manual;
• Support the United Methodist Church, its Doctrine and Social Creed;
• Be open to personal spiritual growth through this experience;
• Be willing to share my unique gifts while honoring the gifts of others;
• Act only in ways that will offer glory and honor to God and God’s gift of community and creation;
• Live by the understanding that, as a person in authority, it is my responsibility to avoid inappropriate physical contact with children/youth in my care, even if a participant attempts to initiate the contact;
• I will not participate in hazing;
• Refrain from verbal abuse, including put-downs, inappropriate jokes, sarcasm, and racial/other types of slurs;
• Refrain from contacting/fraternizing with children/youth after the activity unless in the capacity of a leader;
• Find alternative methods of discipline, agreeing that under no circumstances will I use spanking, neck or choke holds, ear or hair pulling or any other corporal punishment as a means of discipline (no matter what my personal relationship to children in our program);
• Make it my primary responsibility to minister to the needs of the children/youth and not my own, with Christ as my example;
• Be in prayer for this activity, other leaders and participants attending;
• Accept, respect and be responsive to multicultural diversity;
I have read and agree to follow this Children and Youth Leader Covenant.
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Yes
Typing your name in this box will serve as your digital signature as it related remaining in compliance with the Safe Sanctuaries Policy of St Paul's UMC
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