SAFE IN JESUS ARMS BACKGROUND CHECK

We require any volunteer working with kids ages 18 and under to fill out a background check. Thank you for your willingness to help further the kingdom of Christ. For volunteer ages 18 and under please fill out the form below:

Name

First Name

Last Name

Email Address

Address

Phone

Program you will be helping with?

During your lifetime have you ever been accused of the exploitation of a minor, physical assault or sexual offense of any kind?

no

yes

If yes, please explain

Are you listed on the sexual offender registry of any state?

No

Yes

As a child, were you ever molested, abused, assaulted or subjected to a sex offense of any nature?

No

Yes

I hereby certify that I have read and completed the above screening form. My answers are true and correct to the best of my knowledge. Please sign full name below:

Date

Parent or Guardian Full Name

To read Redeemer "Safe In Jesus' Arms" policy, click here.