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The following is the Saint Luke's Presbyterian Church Child and Youth Protection Policy, as required for everyone who participates in any ministry alongside anyone under the age of 18 at Saint Luke’s. Please make sure to read all items below carefully and sign where indicated.  



As members of this congregation and of the Body of Christ, we covenant to undertake the Christian nurture of each child. Our commitment to nurture means that we will help care for children by providing them with a safe environment, as well as teaching them the gospel and living out the faith as positive role models. In keeping with that covenant, this policy also provides adults with clear guidelines for working with and caring for children and youth.

Policy:

1. Children and youth are defined as persons from birth to 18 years of age. Youth who serve as volunteers with children will receive child and youth protection training.

2. No person with substantiated incidents of physical or sexual child abuse, exploitation or other forms of sexual misconduct will be allowed to work or volunteer in any position involving children or youth.

3. Employees and volunteers in designated positions (as determined by the appropriate Session committee) will receive child and youth protection training.

4. Employees and volunteers in designated positions (as determined by the appropriate Session committee) will be subject to background and / or driver’s license checks. A consent form will be provided.

5. The following behaviors by any employee or volunteer are prohibited: a. Physical striking, hitting, or spanking a child or youth. b. Touching in an inappropriate or sexual manner. c. Verbally or emotionally abusing a child or youth, including use of sexual innuendo.

6. At least two (non-spousal) adult workers shall be present at all activities involving children or youth. At no time will only one worker be allowed to be alone with a child or youth. The only exceptions to the two-adult rule would be situations in which the adult and child or youth are in a public place or other persons are in and out of the area or room. In such cases, classroom doors shall remain open. The policy is not intended to restrict appropriate pastoral counseling and care-giving.

7. I understand that, under Georgia State Law, I am a mandatory reporter, and will report suspected abuse and/or neglect within 24 hours to Child and Family Services and notify a program staff member of Saint Luke’s.

8. Once a program staff member has been notified, the following procedure will be followed:

a. The staff member and the person reporting will complete an incident report.

b. The Pastor/Head of Staff will be notified.

c. The Pastor and appropriate staff member, will document all steps taken in the course of handling the reported incident.

d. If the incident took place during a church function, the Pastor and/or appropriate staff member will notified the parent/guardian of the suspected victim as soon as possible of the incident.

e. Only the appropriate law enforcement authorities will carry out in-depth investigation. In cases where a member of the employed church staff is accused, the Rules of Discipline of the PCUSA shall also apply.

f. The church will minister, as possible, to individuals who in good faith make reports of actual or reasonably suspected cases of abuse, to those who are accused, and those who are abused. All reports will be taken seriously, but not judged prematurely.

g. Any person accused must be treated with dignity and support. That person will be immediately relieved of further responsibilities until the investigation is completed and allegations are cleared by authorities.

h. To the extent possible, confidentiality of all persons involved will be safeguarded. Agreement to Serve: I have received, read, and understand the Saint Luke’s Presbyterian Church Children and Youth Protection Policy and agree to abide by it. I agree to observe all policies and procedures regarding working with children and youth. Furthermore, I have never been convicted of a child / youth sexual / physical abuse crime. I have never been nor am I currently involved in any abuse of a minor as described above.


First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

Last Name*
Second Participant's Date of Birth*
Third Participant's Name

First Name*

Middle Name

Last Name*
Third Participant's Date of Birth*
Fourth Participant's Name

First Name*

Middle Name

Last Name*
Fourth Participant's Date of Birth*
Fifth Participant's Name

First Name*

Middle Name

Last Name*
Fifth Participant's Date of Birth*
Sixth Participant's Name

First Name*

Middle Name

Last Name*
Sixth Participant's Date of Birth*
Seventh Participant's Name

First Name*

Middle Name

Last Name*
Seventh Participant's Date of Birth*
Eighth Participant's Name

First Name*

Middle Name

Last Name*
Eighth Participant's Date of Birth*
Ninth Participant's Name

First Name*

Middle Name

Last Name*
Ninth Participant's Date of Birth*
Tenth Participant's Name

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
Parent or Guardian's Email Address

Email*

Confirm Email*
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Parent(s) or Court-Appointed Legal Guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the Parent or Court-Appointed Legal Guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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