Introduction

This form is to be completed by an applicant for any volunteer position within the Liberty Grace Church involving the supervision or custody of minors or the developmentally disabled, and for any paid staff member, regardless of his/her job responsibilities. It is being used to help church leaders provide a secure environment for those children, youth and developmentally disabled persons who participate in our programs and use our facilities.

(INFORMATION RECEIVED IS STRICTLY CONFIDENTIAL)

Applicant’s Statement

By submitting this application you agree to the following:

I hereby acknowledge that the information contained in this application is correct to the best of my knowledge. I authorize any references or churches listed in this application to give Liberty Grace Church any information they may have regarding my character and fitness for children’s ministry, and I release all such references from liability for any damage that may result from furnishing such evaluations. I also grant my permission for Liberty Grace Church to perform a personal Criminal Record Check for the purpose of my protection against any false allegations and for the protection of those I serve. I consent to such an investigation with the understanding that the results will be kept in extreme confidentiality. I further agree to adhere to the Child Protection policy as adopted by Liberty Grace Church.