Friendship Baptist Church, 8580 Cheviot Road, Cincinnati, Ohio 45251 PH (513) 741-7017  Directions

 

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Child Safety Program

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       Friendship Baptist Church

                       Children's Ministries

                 Annual Worker Update

 

This update is to be completed by all Children's Ministry Workers (and Teen Helpers) annually.  It is being used to help the church provide a safe and secure environment for those children and youth who participate in our programs and use our facilities.

 

Enter Application Date: Format 00/00/201x*
Enter Date of Birth: 00/00/201x*
Enter Full Name: *
First Name
Middle
Last Name
Enter Address: *
Address Line 1
Address Line 2
City
State
Postal Code
Enter email:*
Enter Home Phone:*
Enter Cell Phone:
Enter Employer:
Enter Job Title:
Are you permitted calls at work
Work Phone and Ext:
Ministry area(s) in which you have served in the past year:
Within the past two years have you been accused of sexual or physical abuse?*
If yes, please explain
Within the past two years, have you been convicted of child abuse, or of a crime involving actual or attempted sexual molestation of a child:*
If yes, please explain
Do you have a current driver's license:*
If yes, please list number:
Please list all convictions (traffic & non-traffic related) for the past two years:

Annual Training

I have reviewed the information contained in the Child Safety Program Procedures and Policies Booklet information and agree to abide by the policies and procedures therein.*

Worker's Statement

The information contained in this application is correct to the best of my knowledge.  While serving as a Children's Ministry Worker, I agree to be bound by the bylaws and policies of Friendship Baptist Church and to refrain from unscriptural conduct in the performance of my services on behalf of the church. I understand that it is the Pastor's prerogative to withhold or withdraw approval status for any activity deemed inappropriate, immoral or illegal.

By submitting this form I am acknowledging that the above has been accurately and correctly stated.