AGFS Insurance Risk Management Guide 2010 - AG Financial Solutions

Insurance Church safety and security.

Risk Management Guide

Dear Friend, I would like to welcome you as a member of the Assemblies of God Program, offered by AG Financial Insurance Solutions. By selecting the AG Program you will receive the benefits of having a customized insurance policy through Church Mutual, as well as the following added benefits: • An easy-to-use risk management guide • Discounted screening services • Access to training events and ministry assessment • Victim support services • A staff attorney’s guidance for incidents prior to and after a claim is filed or during litigation This risk management guide includes important information to help you protect your ministry. A few of the important areas for which practices and procedures are provided in this guide are: • Transportation • Financial protection • Sexual misconduct • Emergency preparation Also included in this guide are many of the forms that you will need in your ministry. Following is a list of some of these forms: • Applications for employees and volunteers • Driver review and training checklist • Vehicle inspections and maintenance form • Facilities use agreement • Church self-inspection checklist • Personal safety and security checklist • Parental permission and medical consent form • Activity participation agreement If you have any questions, please contact us by phone at 1.866.662.8210, e-mail us at [email protected], or visit our Web site at agfinancialinsurance.org. Sincerely,

Jerry Sparks President


Table of contents 3

Introduction

5

Section I Primary areas of concern

7 Section II Establishing a church safety and security team 1 1

Section III Child/youth sexual misconduct

7 1

Section IV Transportation

1 2

Section V Facility inspection, maintenance, and usage

3 2

Section VI Financial protection

7 2

Section VII Emergency preparation

3 3

Section VIII Personal safety and security

9 3

Section IX Property protection

3 4

Section X Insurance matters

47

Risk Management Guide completion checklist

9 Appendix 4 Forms Contents of this guide may be photocopied and used within your organization without permission. Permission must be received for any use beyond the local congregation.


Recognize the issues, know your options. There are dozens of concerns and issues facing ministry that can cause disruptions, loss of resources, and heartache.

866.662.8210 | agfinancialinsurance.org

introduction

Introduction | 3

Obviously, few churches or organizations are able to focus on every issue. With some effort, the primary issues can and should be addressed. By doing so, your ministry could be spared a loss, a claim, an accident causing injury or something more severe. This guide will help you recognize and understand those areas church insurers see on a daily basis. Our hope is that you will utilize the material found in this guide to address these issues. By shifting your thinking from reactive to proactive, you can make a difference. More importantly, caring for the people, property and resources God entrusted to your care is a faithful act of stewardship. The resources in this guide are based on the generally accepted practices and procedures of insurance providers and experts who have worked with religious organizations for many years. These recommendations have been tested, not only in the local church, but also in courts of law. These resources are both practical and necessary for churches and organizations to protect their ministries and defend themselves in court should an accident, incident or claim occur. Courts do not exempt churches, due to their nonprofit status or religious nature, from negligent behavior in their practices and procedures. The carefree days of keeping

your facilities open around the clock, leaving resources and equipment exposed and utilizing poor financial management practices are no longer possible. Recent judgments against churches have been staggering. Many ministries have been crippled or shut down as a result. There is good news: Help is available. Take the time and effort to become educated on these issues. Embrace and implement the practices and procedures to protect your ministry. Further, by staying diligent and faithful when it comes to church safety, security and risk management, you should be able to minimize interruptions to your ministry. AG Financial Insurance Solutions desires to partner with you to provide these resources and work together to see them through to implementation. We are committed to stand beside you as you learn, grow, and take the steps necessary to protect your ministry. We look forward to the opportunity to work with you to help unite safety and security in your ministry.


I will never be shaken. Psalms 30:6 (NIV)


Primary areas of concern | 5

Section I

Primary areas of concern

Many issues and incidents can negatively impact ministry. The goal of any church or religious institution should be to do whatever possible to protect people, resources, facilities and ministries. Doing so is a necessary act of faithful stewardship for every organization and leader. While it may not be possible to protect against every situation, risk management will help not only to recognize a potential risk, but also to minimize, shift and possibly eliminate a risk altogether. Over the years, insurance companies have been able to track and calculate the types of losses that occur most frequently and are most severe. The goal is to minimize the frequency and the severity of such risks. To do this, the primary areas of concern must be identified. Nearly all concerns of churches fall into one of the sections included in this guide. Forms, facts, checklists, and solutions will be provided for each section. The material will be fairly short, easy to follow, and practical.

In the final section of this guide is a Completion Checklist (page 47). Upon your completion of this form and returning it to AG Financial Insurance Solutions, you will be sent a certificate of completion. Your goal should be to develop a written set of comprehensive safety, security, and risk management practices for your church. Those practices and procedures should be your benchmark for keeping your church, people, and ministry safe and secure. The primary areas of concern that will be addressed further in this guide are: • Child/youth sexual misconduct

(Section III) • Transportation (Section IV) • Facility inspection, maintenance,

and usage (Section V) • Financial protection (Section VI) • Emergency preparation (Section VII) • Personal safety and security

(Section VIII) • Property protection (Section IX) • Insurance matters (Section X)


Guard the good deposit that was entrusted to you—guard it with the help of the Holy Spirit who lives in us. 2 Timothy 1:14 (NIV)


Establishing a church safety and security team | 7

Section II

Establishing a church safety and security team Overview Churches, denominations and religious organizations are beginning to see the value of continuity and intentionality when it comes to safety, security, and risk management. The enormous value in taking steps toward protecting people, property, facilities and ministries is now being recognized. It is time to consider the value and power of a church safety and security team (or ministry). This concept gives the organization its best chance at protection for many years to come. Putting the team together It can be hard to get good people to serve. There are certainly those who would embrace this new ministry. Consider those in your congregation who are or have been a part of such vocations as law enforcement, fire protection, the military, or in the fields of medicine, construction, human resources, and insurance. Also consider parents and grandparents who are concerned about the safety of their children and grandchildren. Of this group, there should be four to eight people who may be willing to serve. Bring these prospects together and show a key video (contact us for suggestions) and challenge them to carry out their commitment to God and the church through this exciting, challenging new ministry. All you are asking of them at this point is their willingness to serve. Introduce the team Recognize the team members in front of the congregation. Introduce the team members as those who have been called to offer safety, security protection, and education to the church (see the commissioning ceremony at the end of this section).

With the team now formed, it is important to gather resources and train them. They do not need to become experts but are to become knowledgeable advisors on key issues. This guide provides the tools necessary for that to happen. The next step is for the team to work together to formulate a plan of action. It may be helpful to assign each member of the team a particular function or area of concern. The important thing is to select, train, equip, fund and empower the team to carry out its ministry. After their training is complete, team members can then train the church leadership, employees, volunteers, and congregational members. This training can also be facilitated by outside experts, if desired. The more people are equipped, the better. The team should regularly inform and educate the other ministries of the church regarding safe practices. Ultimately, the team should be seen as an important ministry of the church that works alongside others as they look for ways to do ministry in the safest way possible. By taking this important first step of forming a team, your church or ministry has the best chance possible of maintaining your ministry and sparing your congregation from having to go through a tragedy, accident or horrible incident. It’s the faithful thing to do.


Duties of the safety and security team The following is a brief description of the functions of the safety and security team. Once the team is formed, these guidelines will ensure a consistent, intentional effort when it comes to safety, security, and risk management. Intent While other committees and personnel may have direct responsibility for some of the functions below, the safety and security team should act as a filter, making sure that the functions are being carried out properly and in a timely manner. Some teams may assume other functions as needed by the leadership or congregation. Remember, protecting people, property, and resources is a faithful act of stewardship. Serve with a sense of compassion and joyful service to God and God’s people.

Duties • Commission the team and promote team commitment (see sample commitment/ commission ceremony on page 9) • Meet regularly (at least bimonthly) • Educate and have an educational process for the team • Develop and implement policies and procedures • Regularly inspect premises (inside and outside) and document the same • Coordinate efforts with professional inspectors (electrical, HVAC, etc.) • Train employees and volunteers and educate the congregation in safety and security issues • Provide input and direction on new ministries, building projects, work days, and high exposure activities • Be involved in safety and security for building projects

We highly recommend the training tool Safety Begins with People. You can find it online at: agfinancial.org/rmresources.

• Coordinate safe and secure practices during services and other key events • Protect offerings and other large sums of money • Provide assistance to health and welfare ministry • Ensure that first-aid and emergency response equipment is in working order and up-to-date • Coordinate emergency planning and response plan • Oversee transportation program (church-owned and private vehicles) • Provide input on insurance-related decisions • Coordinate safety and security issues with Board of Trustees • Regularly report to leadership/board • Ensure that regular financial audits are being completed • Coordinate safe hiring and screening practices for employees and volunteers with human resource/personnel committee


Establishing a church safety and security team | 9

Sample safety and security team Commitment/commissioning ceremony Leader: Friends, God has given us the blessings of people, resources and facilities. He calls on each of us to be good stewards and caretakers of those gifts. And to be sure that we, as a congregation of faithful followers are intentional about that task, now call those who have agreed to serve on our church safety and security team (or appropriate name) and ask them to come forward. Many times in Scripture, we see where the faithful were faced with threats that could harm them and keep them from doing the work that God had called them to do. And we see where people of faith were singled out to stand watch, to warn, to protect and to care for the flock. Ezekiel 33:6 (NIV) says: “But if the watchman sees the sword coming and does not blow the trumpet to warn the people and the sword comes and takes the life of one of them, that man will be taken away because of his sin, but I will hold the watchman accountable for his blood.” In Acts 20:28-31a (NIV) we read: “Keep watch over yourselves and all the flock of which the Holy Spirit has made you overseers. Be shepherds of the church of God, which he bought with his own blood. I know that after I leave, savage wolves will come in among you and will not spare the flock. Even from your own number men will arise and distort the truth in order to draw away disciples after them. So be on your guard!” And so to help safeguard our members, our children, our property, our resources and our ministries, we call you to this act of faithful service. And I will ask you, (to members of team): Will you faithfully carry out the duties of this important ministry of protection and care? And will you do this in a manner of compassion and commitment to God and the faithful members of this congregation and community? If so, please answer, “We will.” And as members of the congregation, I ask you (to congregation): Will you do all in your power to support and affirm these committed team members and faithfully work toward a more safe, secure, and just environment within and beyond our church? If so, please answer, “We will.” Let us pray: Gracious and loving God, we know that we all must care for all that You have blessed us with. But we especially commit these safety and security team members to Your care. Help them to use discernment and wisdom as they are called to serve, and empower them to carry out this ministry in our midst. And in all that they and we do, may You be glorified in a mighty way and be pleased with our efforts. This we ask in Jesus’ name. Amen.


He who trusts in himself is a fool, but he who walks in wisdom is kept safe. Proverbs 28:26 (Niv)


Child/youth sexual misconduct | 11

SECTION III

Child/youth sexual misconduct

Overview When people bring their children to church, they should feel good about their safety. To ensure proper safety and security for God’s children, a church must proactively and intentionally develop and follow specific, written practices and procedures. By doing so, the church can continue ministry with an uninterrupted sense of confidence and spare the children and the church much heartache. Nothing can tear a church apart more than a case of sexual misconduct. A church can be embroiled in such a case five years or more. After a prolonged investigation with possible criminal and civil cases, many church leaders and congregations find themselves short of energy, funds, and the will to move forward.

Sadly, in today’s society, offenders know that the church is currently the “path of least resistance.” By that we mean, if most of the other child-serving organizations have safeguards in place to prevent or dramatically reduce the possibility of an event occurring, a potential offender will seek the place that is most lax. Unfortunately, it is often the church. In addition, when we recognize that there is no real standard for identifying or categorizing offenders, we will grasp the importance of having a solid program in place. There are minors offending minors (now believed to be over 25% of all cases), aggressive offenders, experimental offenders, group offenders, and a growing group of female offenders. Our previous notions and minimal screening efforts have to be reconsidered.

Did you know? 88% of sexual abuse cases are never reported to the authorities. (Hanson, R.F., Resnick, H.S., Saunders, B.E., Kilpatrick. D.G., and Best, C. (1999). Factors related to the reporting of childhood sexual assault. Child Abuse and Neglect, 23, 559-569).

In 90% of child sexual abuse cases, the child knows the person who commits the abuse. (Finkelhor, D. (1994). Current information on the scope and nature of child sexual abuse. Sexual Abuse of Children The Future of Children 4 (2), 31-69).

500,000 children are sexually abused each year. (Finkelhor, D. (1994).Current information on the scope and nature of child sexual abuse. Sexual Abuse of Children, The Future of Children 4 (2), 31-69).


As leaders, we need to protect not only the children, but also the leaders and ministry from unnecessary exposure. A safe church environment takes into account a variety of factors. These factors include: Education A wide variety of resources are available to help leadership and congregations understand and adequately address the issues. Safety begins with understanding. Development Take time to develop your policy. Seek examples from other churches, look at what other child-serving organizations do in your area and communicate with various groups and leaders in the congregation as you work toward completing your practices and procedures. Implementation Begin the implementation of the practices and procedures by holding training and communicating with the congregation and leaders using all forms available. Some churches have begun their implementation by screening all new employees and volunteers, and slowly incorporating background checks for those already in place. The important point is to start and move the program forward. Supervision Regardless of how good your policies are, if you don’t adequately supervise the children and those who work with them, you are leaving yourself open for problems.


We highly recommend the training tool, Safety Tips On A Sensitive Subject: Child Sexual Abuse. You can find it online at: agfinancial.org/rmresources.


The Sexual Misconduct/Child Protection Policy Components One of the most difficult issues to overcome in the life of any ministry is the allegation or confirmed incident of violation of a child. Not having a written policy or failure to follow a written policy increases the likelihood that an incident may arise. Having a written policy that is understood and followed not only protects possible targets, but also shields the adult caregivers and the entire ministry of the church.

Definition of terms Know how your state defines such terms as “sexual abuse,” “neglect,” “mandatory reporter,” “physical abuse,” “sexual abuse,” and “harassment.” Practices and procedures • Address hiring and selection procedures, including applications, reference checks, background checks, and interview and selection process. • Address similarities and/or differences in procedures for employees, volunteers, and mentors. • Clarify supervision and ratios.

Some churches find a policy or borrow one from another church, place their name on it, and call it their own. Not only is this ineffective, it can have terrible repercussions if ever the church were forced to defend itself in court. Regardless of where the policy originated, if it is seldom reviewed or followed, the same results can occur. Ideally, it is best to start with a framework and build a policy that is specific to your congregation. It takes time, but such a policy has a much better chance of protecting people and ministry. The following components should be a part of the policy: Summary of the issues and rationale Describe the scriptural, moral and ethical reasons for implementing such a policy. Provide statistics and the impact of such an event on the life of the individual and the church.

• Utilize reporting procedures. • Detail consequences to violations of policy. • Apply acceptable counseling procedures (of adults and minors). Job descriptions Have job descriptions for each position (employee and volunteer) to help regulate what is and is not acceptable behavior. Conclusion Have every employee and volunteer who works with minors read, sign, and date the policies to confirm their understanding. Developing your own policy is a giant step in protecting people and your ministry. Before adopting your policy, consult legal counsel in your area. Make sure they concur with your policy; make changes as they deem appropriate.


Commonly accepted best practices for church sexual misconduct prevention

Allegation Plan

The following best practices are recommended to allow your organization the best chance of preventing incidents of sexual misconduct. Such standards are accepted by the vast majority of youth- and children-serving organizations. They include:

An allegation response plan should be in place and include the following:

• Written applications for employees and those volunteers working with children and youth (See form in Appendix)

2. Taking the allegation seriously and

• A thorough interview process • Background checks and reference checks on all current employees, new hires, all volunteers who work a considerable amount of time (two hours or more a week) with minors or the disabled (physically or mentally), and those who have keys to the facilities • Reference checks on all volunteers who work an appreciable amount of time with minors or the disabled (greater than one hour/month but less than two hours/week) • A designated safety, security, and/or risk manager or team who is responsible for implementing/maintaining an abuse prevention and control program for the church • Regular training on abuse prevention/control to all paid staff and volunteers who work with minors • Six-month waiting rule restricting direct supervision of children or youth to those who have been in good standing with the church or organization for a minimum of six months • A policy that no child should be alone with an adult (formerly referred to as the two-adult rule) • Written job descriptions for employees and volunteers • A written sexual abuse/molestation control plan that outlines the points above


1. Understanding what sexual abuse/

misconduct is as defined by state mandatory reporting law for child abuse addressing it promptly 3. Documenting the allegation 4. Reporting the allegation to proper

authorities as required by state reporting statutes and to your insurance company 5. Offering professional assistance to

the alleged victim when needed (e.g., attorney services) 6. Finding victim support 7. Responding to the alleged perpetrator,

congregation, and media By taking steps to follow these best practices*, you will have joined thousands of others who are committed to protecting children, youth, workers, and organizations from the devastating impact of sexual abuse and misconduct. *These best practices are taken from Reducing the Risk 2 and used by permission of Christianity Today.


Recommended ratios for supervision of minors The following guidelines are taken from a variety of sources and constitute the best practices to follow for churches, day cares, camps, and other youth/minor events. In no scenario should a child ever be alone with an adult or other child. The “two-adult” rule or the more current “no-child-left-alone-with-an-adult” rule should be followed. Staff/child ratios at child-care centers and classroom settings The National Association for the Education of Young Children provides the following guidelines for staff/child ratios at child care centers. The care you provide should follow these guidelines: Recommended Staff/Child Ratios Within Group Size.* Age of Children

Group Size 6

8

10

12

14

16

18

20

1:7

1:8

1:9

1:10

4-year-olds

1:8

1:9

1:10

5-year-olds

1:8

1:9

1:10

Infants (birth to 15 mos.)

1:3

1:4

Toddlers (12 to 28 mos.)

1:3

1:4

1:4

1:4

1:4

1:5

1:6

21 to 36 mos. 2½-3-year-olds

Kindergartners

1:10

22

24

1:11

1:12

30

*Smaller group sizes and lower staff-child ratios have been found to be strong predictors of compliance with indicators of quality such as positive interactions among staff and children and developmentally appropriate curriculum. Variations in group sizes and ratios are acceptable in cases where the program demonstrates a very high level of compliance with criteria for interactions, curriculum, staff qualifications, health and safety, and physical environment.

Recommended staff/child camp ratios: 6-8 years old, 1 counselor to 6 campers 9-14 years old, 1 counselor to 8 campers 15-18 years old, 1 counselor to 10 campers Note: As isolation increases, ratios and supervision should also increase.


Youth mentoring guidelines Mentoring has long been viewed as a valuable method for training minors in the church. While we do not discourage mentoring, we strongly suggest that specific practices be in place to protect not only the minor, but also the mentor. 1. Always meet in a public place (restaurant,

coffee shop, school, or open area of the church with others nearby). 2. If transportation is necessary, it is preferred

that the parent drop off and pick up the child from the public meeting place. 3. An adult should never be alone with a child.

A mentor couple or small group emphasis is preferred (two unrelated adults and two minors). 4. Clearly communicate when and where the

meetings will take place. Have mentors communicate clearly with the parents as to when the meeting will begin and end and stick to it. 5. Have the mentor complete an application. 6. Check the mentor’s references. 7. Screen all mentors with a national criminal

background check. 8. Mentors should be of the same sex as

the minor.


9. If possible, set up group mentoring times

and locations where several adults and minors may share time together privately but also be seen or be in proximity to other mentors and youth. 10. The only time mentors and youth should

meet in homes would be in the child’s home with parents present. 11. Have a clear reporting procedure for any

issues that may arise. 12. Provide an alternative for those parents

who wish to opt out of a one-on-one mentoring arrangement. Mentoring can be a valuable tool for the church, but in this age of litigation, allegations, and incidents, it is wise not to expose your church to liability unnecessarily.

Transportation | 17

SECTION IV

Transportation

Overview Every year, dozens of stories are reported involving a church group in an accident. One can only imagine receiving a phone call that the youth have been involved in a serious accident on their way to a mission trip or a member of the women’s Sunday School group was killed on their sightseeing trip. Inevitably, from such a tragedy will come questions, accusations and guilt. Could the accident have been prevented? The good news is there are measures that, when taken, can greatly reduce accidents, injury, and other problems relating to transportation. While some accidents may be unavoidable, many result from poor planning, inadequate training, unsafe vehicles, or passengers and drivers not following safety practices. Vehicle selection, inspection and maintenance Whether the vehicle being used is owned by the church or privately owned, many of the same safety issues are present. All vehicles should be safe. The only way to ensure safety is a systematic, regular inspection, and maintenance procedure. For church-owned vehicles, this should be done on a regular basis. All inspections and maintenance activities should be conducted and documented by a qualified mechanic. Though many churches may not inspect privately owned vehicles, such actions can save lives. This is especially true when using private vehicles for long-range trips. A general look at the vehicle’s mechanics, tire wear, and seat belts is important. Driver selection and training How does a church develop a list of approved drivers? Once again, whether using drivers for church-owned or privately-owned vehicles, many of the same standards should apply. It is important to know if drivers have traffic violations. Do they have adequate insurance? Are they experienced? Have they been trained in the specific vehicle they are driving? What consideration has been given to screening drivers involved with transporting minors? All of these questions should be answered well in advance of a trip.

We highly recommend the training tool The Road to Safer Transportation. This can be found online at: agfinancial.org/rmresources.


Safe travel practices It is important to discuss what practices will be followed during the trip. Safe travel includes proper driver rotation and rest, requiring the use of seat belts by passengers and drivers, limiting cell phone use and distractions, and knowing when and how to stop in case of an emergency. Further, it is important to discuss what to do if someone has a medical emergency on the road, especially if it involves a driver. Finally, you should consider a plan for those rare cases when you need to send a child home while on the road.

Pre-trip planning A long road trip requires adequate planning beyond simply loading up the vehicle and tossing someone the keys. Consideration should be given to: • Responding to emergency situations • First-aid kits and supplies • Communication between vehicles • Number of people in each vehicle • Packing of the vehicle to ensure safety • A safety briefing for passengers where they affirm that they have been advised of safe practices

Taking the time and energy to adequately • Number of drivers needed plan for any road trip can save lives. It’s that • Maps and contingency routes simple. No church wants to notify parents or other family members that one of their • Permission slips children or loved ones has been injured or killed. Every church should have a written transportation policy and a designated person (often someone from your Safety and Security For more transportation and safety Team) to ensure its implementation. Being information, visit the National intentional and documenting your actions Highway Transportation Safety should be a high priority. Administration Web site (nhtsa.gov).


Transportation | 19

Concerning 15-passenger vans The safety issues concerning the 15-passenger van have been well documented by numerous authorities and church leaders. Because of these concerns, we ask that you seriously consider alternative forms of transportation. However, if you are not immediately able to move out of your 15-passenger vans, we ask that you follow the guidelines of the National Highway Transportation Safety Administration. While following these guidelines will make the operation of the 15-passenger vans “safer”, the best choice is to replace them with vehicles that are safer to operate by design. • Don’t load over 10 passengers • Have all passengers sit in front of the rear axle • Place all cargo in front of the rear axle • Do not tow a trailer or place luggage on the top of the van

Trip safety kit contents To ensure you have the necessary items needed in the event of an accident, injury or problem on your extended trip, use the following in preparing for each trip: • Communication devices (cell phone,

walkie-talkies) • List of emergency contact numbers • Current maps and directions • Bottled water • Blanket • First-aid kit • Moist wipes • Emergency food supply • Operating flashlight with extra batteries • Flares or emergency markers • Vehicle registration information • Insurance information

• Check tires for excess wear and tire pressure

• Jack and functional spare tire

• Require seat belt and/or child restraint usage by all passengers

• Jumper cables

• Never drive a van over 60 mph

• Health and “consent to treat” forms for

• Engage in any corrective maneuver slowly • Use only trained drivers • Ensure that drivers are well-rested • Maintain safe speeds for the road and weather conditions In addition, we suggest: • Keep the gas tank at least half full • Have communication devices and first-aid kits in all vans

• Dry chemical fire extinguisher

all travelers (see Appendix) • Accident reporting form (see Appendix)


Keep watch over yourselves and all the flock of which the Holy Spirit has made you overseers. Be shepherds of the church of God, which he bought with his own blood. Acts 20:28 (Niv)


Facility inspection, maintenance, and usage | 21

SECTION V

Facility inspection, maintenance, and usage Overview The most frequent claims reported in churches are slips, trips, and falls. Though they may not grab headlines, their high frequency of occurrence is certainly problematic. Many of the losses that stem from the lack of facility inspection and maintenance are preventable. A systematic, detailed approach to inspection and maintenance results in a reduction of losses. To further minimize losses, churches who use outside vendors (i.e., lawn care companies, etc), should utilize a Vendor Agreement form (see Appendix) and be named as an “Additional Insured” in the vendor’s policy. Otherwise the church could be held responsible should there be negligence on the part of the vendor.

The Appendix contains the basic forms necessary to do a self-inspection. These inspections should be done at least quarterly by a designated person or team. A system should be in place for regular attendees and members to point out hazards. Procedures should be adopted that make maintenance a priority. Once notified of a hazard, church leaders could become liable for not making timely repairs should an injury later occur due to their slow response or inadequate repairs. Inspection and maintenance should be viewed, along with the entire safety/security/ risk management ministry, as an opportunity to be good stewards. Caring for the people, property, and resources God has entrusted to your care is an important ministry for the faithful and should not be taken lightly.

Utilize the safety and security team in your church. The team can implement the checks and balances needed to keep the facility and the people safe. (Refer to page 7 of this guide for additional information regarding creating a safety and security team). Regular inspections and timely and proper maintenance is necessary to lower the odds of having a claim or traumatic event. While many of the jobs can be handled by volunteers, some should be undertaken only by professionals. It is important to keep a list of contractors and maintenance people who can get a job done quickly and safely.

We highly recommend the training tool Improving Safety At Your Worship Center. Find it online at agfinancial.org/rmresources.


They and their descendants were in charge of guarding the gates of the house of the Lord—the house called the Tent. 1 Chronicles 9:23


Financial protection | 23

SECTION VI

Financial protection

Overview Protecting the assets God has entrusted to our care is a faithful act of stewardship. Practices and procedures must be in place to reduce the possibility of theft and misappropriation of funds. Even within the church, it is possible that members, leaders, and those who handle finances could be tempted to take advantage of a situation in the absence of adequate safeguards to protect church finances. Several areas within the financial arena can provide a tempting target. Consider those vulnerabilities, take the necessary precautions and have practices and procedures in place to protect the financial assets of your church. Personal finances Churches should educate their members and staff about safeguarding their finances and valuables. Keeping purses with them or locked in a classroom, not leaving money or valuables in coat pockets, and being alert for suspicious people can help reduce theft. Ushers and collections Ushers should be trained to be alert for suspicious activity during the worship service. Ushers should collect and secure the offering as soon as it is received. It is no longer a safe practice to leave money on the altar during the service. Instead, two ushers should take the money to a locked room and secure the funds immediately after the collection is taken. In addition, it is suggested that funds be stored behind at least two locks (door and cabinet) or in a safe. Securing funds Some churches count the funds immediately after a service. Others will wait until the following day. From the time the funds are collected until the funds are deposited, two unrelated adults should be with the funds at all times. No one should ever be alone with church funds or be allowed to take money home. Also, any collection boxes or loose funds around the church should be collected and secured daily.

We highly recommend the training tool Crime-Proof Your Worship Center. Find it online at: agfinancial.org/rmresources.


Counting Churches count their funds in a variety of ways. In whatever manner the money is counted, two or more people should always be present. Counting should be conducted in a locked room, preferably without windows. Once the count is completed, those counting should verify the figures by signing off on a form to include the time and date. One copy should stay with the money and another should be kept in a separate location.

Special funds One area of concern relates to special funds. These funds come from events such as bazaars, concerts, meals, or other events where funds are generated. The same basic rules apply as with a collection. Secure the money as soon as possible, have at least two people count and verify it, and make a deposit using at least two people. Again, these funds should not be taken home or counted alone.

Depositing Again, for the safety of the person making the deposit, it is best if two people go together to make the deposit. If not, a locked bank bag should be required, and the person making the deposit should not have the key. Further, placing the bank bag into another bag will keep anyone from knowing that you are carrying the deposit. Finally, it is a prudent practice to alternate those depositing the money and which route they take to the bank.

Financial workers It is good to have alternating teams count and deposit the funds. By doing so, it prevents the same person or team from being able to take advantage of the system. By alternating people, it provides you with another layer of checks and balances. It is also wise to conduct a financial check and bond those people who handle funds on a regular basis.

Internal controls There should be clear lines of separation among those who collect, count, and make the deposit, as well as the treasurer, and financial secretary. Never should the same person count, make the deposit, write checks, and provide the financial statement. It is not that they are not to be trusted, but by giving each individual an individual task, you provide a more solid defense should an accusation ever be made. Further, it is best to require two signatures for checks exceeding a specified amount (e.g., $100, $500, or $1,000).


Audits Some churches conduct their own internal audits. While this should be done, it is still wise to have an outside person or firm conduct an audit every two to three years. This raises the level of accountability and keeps a potentially illegal activity from going on for a long period of time. Purchases Any purchases by staff and volunteers should be conducted through a voucher system. At minimum, all expenditures should require a receipt and should be rectified and audited on a regular basis. Good record-keeping for even the smallest item should be a part of your system. All reimbursements and credit card accounts should be reconciled on a monthly basis.

Financial protection | 25

Detecting problems and responding to an allegation We do not expect funds meant for ministry to be stolen, but it does occur. Often, it is done by the person least suspected. Unusual behavioral patterns or unclear or changed entries in the books could be a sign of financial misconduct. If there is an allegation or even suspicion, it is important to respond quickly, have an audit completed, and attempt to restore integrity as soon as possible. It will be your choice as to whether to press charges and demand repayment; each case is different. But remember, you may also owe it to the members who contributed those funds to provide a complete disclosure and accounting. By considering these vulnerable areas and proactively taking steps to guard against potential theft, your church can feel good regarding the safety of its finances.

Offering/Counter’s Sheets There are a wide variety of forms used to count and reconcile the offering. Some churches use a separate sheet to record cash and checks only (see Appendix for sample form). Others will include the various fund categories that donors can designate their giving. Some have a place to record the envelope number. Some larger churches have counting machines or do everything on the computer. Regardless of what form is used, the following practices should be followed.

Procedures for counting the offering 1. All forms should be dated. If there are

multiple services, you may choose to separate or combine the collections. 2. There should be a place to reconcile

the checks and cash separately. 3. At least two (three preferred) should

always count the offering, reconcile the totals, and sign off that they have done so. 4. A copy of the sheet should be kept

with the deposit, and another copy should be kept separately (in case the funds are stolen or come up missing). This additional copy is also handy for use when conducting an audit. 5. Counters should rotate periodically. 6. A spot audit should occasionally be

done on the counter’s forms.


The highway of the upright avoids evil; he who guards his way guards his life. Proverbs 16:17 (Niv)


Emergency preparation | 27

SECTION VII

Emergency preparation

Overview While we often plan for emergencies in our homes or businesses, a large number of churches have done little to safeguard their people or property in the event of a catastrophe–natural or otherwise. Adequate preparation might not only save life and property should an incident occur, it might prevent an incident altogether. Protecting the people, property, and resources God has given to our care is a faithful act of stewardship. Churches should reach out quickly and respond to those in need. And understandably, churches often engage in ministries with risk attached. However, you can choose to manage, reduce, eliminate, or transfer that risk without compromising ministry. That’s what good emergency preparation and response is all about. We should prepare for the worst and respond with our best.

Consider the following from the hurricanes of 2005: 1. Thousands of felons (including many sex offenders) were displaced. While churches reached out as people of faith, many of these violent, dangerous offenders were unknowingly welcomed into churches and the homes of their members, placing people and ministry at risk. 2. Some denominational officials reported that many of their member churches responded without a plan, exposing their ministries to significant risk. 3. Churches borrowed vehicles and loaded them up with supplies and drove through the night with unscreened drivers to deliver them. The work teams slept in unsafe, unsanitary conditions and often became ill. Such trips could expose the church to liability. 4. Some churches pulled people out of assistance lines and helped feed, clothe and shelter them. This act of assistance was offered; not realizing that in doing so often hindered those people from receiving government assistance in the future.

There are three areas to consider. First, we need to plan for those incidents that happen within our congregation, such as intruders, theft, a tragic death, emergency evacuation, a storm, or some violent act. Second, we should consider how we are prepared to respond to a local or regional event such as a flood, civil disturbance, chemical spill, feeding or sheltering people. Third, should there be a terrorist attack, catastrophic weather event, or other national event; a good plan can mean the difference in being a part of the solution or part of the problem.


Crisis ministry is about saving lives and ministering to people. Those who have chosen to take a proactive approach to emergency planning and preparation have realized that though the work is often timeconsuming and difficult, it is the right thing to do. Once you emerge from an event, you will be able to be counted as one of the churches that really made a positive impact in spite of the event. Organizing an Emergency Preparation and Response Ministry Today, churches are recognizing the need to be ready to respond to an emergency. Whether it happens to the church, community, or nation, a faithful and effective response to emergency results only from planning. Distinct purpose A church safety and security team is highly recommended to address all of the church’s safety, security, and risk management issues (refer to Section II). Emergency planning and response, however, is a more focused ministry. This team should be designed to meet physical, spiritual, and medical needs in the event of an emergency. Communicate the need Convince your leadership teams of the need for this ministry. Help them understand the power behind this ministry and the consequences of not being prepared.


Create the team Gather a committed core of professionals and volunteers who are passionate about responding to the needs of people with the love of God in times of crisis. This team should include medical personnel, pastors, counselors, and a large number of volunteers who can respond to and perform the duties necessary in event of an emergency. Volunteers may choose to be involved in the actual emergency response but also may be valuable behind the scenes in preparing supplies, kits, resources, and support. Look to men’s, women’s, and missions groups. Don’t overlook other individuals in the congregation who may not be involved in a ministry. This can be a wonderful ministry opportunity for them. Select a coordinator Once the core group is assembled, select someone to act as director or coordinator. Duties The team will need to identify all of the potential disasters and emergencies and be ready to respond. Searching Web sites, such as those listed on page 30, will help you detail the many aspects of your response. See page 31 for a list of emergencies that require an advance-planned response.


Define your scope Decide if you will be prepared only for an internal emergency (something happening within your congregation) or whether the church will be prepared to provide food, shelter, and other support in the event of a more widespread emergency.

Conduct training Spend time training your team and volunteers. Knowing what to do is essential, but being able to act quickly and efficiently takes practice. Again, coordinate training with other churches and service providers in your area.

Consider community partners It is also beneficial to meet with other area churches to discover what unique aspects of ministry each can provide. Try to avoid duplication; identify the various needs that may arise and identify which congregation will respond to which need. Some may be able to provide feeding centers; others could offer shelter; some may be able to respond with medical help; and others might be able to maintain a stocked clothing and supply inventory.

Contact your insurance agent It is always wise to make sure that emergency response ministries are covered under your policy. Usually they are, but contact your insurance representative to ensure that you are fully covered.

It is also wise for church leaders to meet with other local and regional emergency providers such as the Red Cross, state and local disaster directors, and others to work together in the event of an emergency. It is imperative to coordinate and plan with other churches and agencies to avoid duplication and ensure that all needed services are available. Gather equipment and supplies Once a director, a team, volunteers, and a plan are in place, make sure that you have the equipment and supplies necessary to respond.

Consider the alternative For many, an emergency preparation and response ministry could mean the difference between life and death, or hope and despair. An emergency preparation and response ministry is about people who are willing to prepare, respond, and act in a way that will bring hope and help to those who need it most.


Disaster Recovery Plans for Churches The following Web sites are recommended for viewing samples and accessing resources that will assist your organization in developing a plan suitable for you. We do not endorse or support any of these organizations, but offer them as a resource. Assemblies of God Disaster Relief www.ag.org/disaster North American Mission Board (Southern Baptist) www.namb.net Disaster Relief Agencies www.disastercenter.com/agency.htm Lutheran Disaster Response of Ohio www.ldrohio.org Christian Emergency Network www.christianemergencynetwork.org FEMA www.fema.gov Department of Homeland Security www.ready.gov Nonprofit Risk Management Center www.nonprofitrisk.org Convoy of Hope www.convoyofhope.org



Potential Disasters and emergencies The following are those areas a church Emergency Preparation and Response (EPAR) ministry should recognize. Consideration should be given to what response is required for each area. Your list and responses would be the basis for your written plan.

Community events 1. Civil disturbance 2. Hazardous chemical spill 3. Severe weather 4. Mass destruction or displacement 5. Providing emergency shelter and/or support (e.g., feeding center)

Internal events (to your personnel and facilites)

National events

1. Lockdown of facilities

1. Homeland Security Advisory

2. Intruder, weapon, threat

2. Nuclear, biological, chemical

3. Suicide (actual, threat, or attempt)

3. Other national incident

4. Kidnapping, abduction, or missing person

4. Traveling to respond to national disaster

5. Death a. Staff/volunteer b. Church member c. Family member d. Minor 6. Accident or serious injury (on and off site) 7. Medical emergency or assessment 8. Fire, explosion 9. Bomb threat 10. Bomb or suspicious device 11. Assault 12. Robbery, theft 13. Poisoning 14. Severe weather a. Hurricane b. Flood c. Tornado d. Earthquake e. Blizzard 15. Safe shelters within facility 16. Electrical outage 17. Utility shut-off 18. Church/school closing 19. Spilled body fluids 20. Child abuse report


Listen to my instruction and be wise; do not ignore it. Proverbs 8:33 (Niv)


Personal safety and security | 33

SECTION VIII

Personal safety and security

Overview There is nothing more valuable to a ministry than its people. The individuals and groups that make up your congregation are the backbone of ministry. They give their time and gifts to keep the church moving ahead. It is important to protect the people God has led to our church. It is good stewardship and an important ministry to be proactive when it comes to protecting people. This includes church employees as well as church attendees. Those who attend your church come to learn about God, engage in ministry and cultivate their faith. The church is seen as a place of safety, socialization, and a place where they can continue to be involved in ministry in their later years. The safety of the church staff should also be a priority. As an employer, the church should always be in compliance with both state and federal guidelines and also work to ensure the safety of the workplace for its employees. This section will consider the various groups and provide aids to ensure their protection. By taking these well-designed suggestions, and with a moderate amount of change, your ministry will be able to move forward confidently. That confidence will result from knowing your people are protected, and your ministry is more secure.

We highly recommend the training tool Preventing Workplace Injuries Is No Accident which can be found online at: agfinancial.org/rmresources.


Personal Protection (for the primary groups within the church) Children and youth Sexual misconduct (refer to Section III in this guide for information on sexual misconduct) along with other accidents and incidents involving children and youth can fracture an entire church ministry. Many of these accidents are preventable, with concentrated effort. The Personal Safety and Security checklist, found in the Appendix, details these areas, but following are some summary points to consider: Set-up and equipment of the nursery and children’s areas The nursery area can be a wonderful place for little ones to receive nurturing and care, but it can also be filled with hidden dangers. (Please also see the helpful information in our section on facility inspection, maintenance, and usage.) The key is to designate someone to regularly inspect the nursery and children’s area. Playground facilities Playgrounds can fall into disrepair if not properly maintained. Also, playground equipment and the designated area sometimes are not designed according to safety standards and present an immediate hazard. Again, knowing what equipment and surface materials are considered safe and implementing a regular inspection program can protect the children. Supervision of children and youth Volunteers, teachers, and youth leaders are a valuable asset to any ministry. Seldom do churches have enough adults to fill all available positions. Utilizing policies and procedures can be of invaluable help. Let youth and children’s workers know what is expected of them, and provide training. Make sure that they understand that it is more important to protect those entrusted to their care than to be popular or well-liked. 866.662.8210 | agfinancialinsurance.org

We highly recommend the training tool Safety At Your Playground which can be found online at: agfinancial.org/rmresources.


Extreme activities and equipment A popular trend involves extreme sports for youth. Churches are reaching out to young people through skateboard parks, rock and wall climbing, and various contact sports. Since these activities can be dangerous, this is one of the fastest growing claims categories.

Training staff and volunteers Regardless of the activity, it is important to communicate with staff and volunteers. Unless a regular training component is built into your policies, practices, and procedures, training often does not occur. Make sure that policies and procedures are in place and are utilized.

When engaging in extreme sports or activities, a professional who is trained and certified in that activity should inspect the equipment prior to each use to make sure that it is safe and in working order. Training adult supervisors and participants is critical, and shortcuts should never be taken. Furthermore, an Activity Participation Agreement (see form in Appendix) should be signed by a parent or guardian explaining the activity and the inherent risks.

Setting boundaries When working with children and youth, who naturally seek to stretch boundaries, it is critical to have clear, communicated boundaries and consequences defined in advance. If the rules are broken, and consequences are not enforced, not only will that young person not be served, but others in the group will take note. As difficult as it may seem, having a parent pick up their child from an event for misconduct, or requiring someone to sit out of an event can send a strong message to that person and the rest of the children gathered.

Did you know? • More than 12,000 children 0 to 19 years of age die each year in the U.S. from unintentional injury. • Childhood falls account for more than 2 million emergency room visits each year. • The most common causes of injuries seen in emergency departments are from traffic accounts, falls and violence.

Parental supervision while at church Parental supervision can become an issue in churches. After children are released to their parents, parental supervision is not always adequate, and children can get into trouble or harm themselves or others. If you detect an issue with parental supervision, place announcements in the bulletin or newsletter. If it continues, send a firm but loving reminder home with the children asking parents to supervise their children for the safety of the children and others. If inappropriate behavior continues, additional steps may be necessary. Show kindness to the kids and parents, but stress the need for safety for all members, emphasizing that it is important to the church and ministry.


Protection of members It is important to remind members of the importance of locking their cars, keeping their valuables with them at all times, and using caution while in the building. This can be done in a way that communicates love and concern for their well-being.

Seldom do we think about keeping that group of people safe and secure, but we must take the time to care for the least of these in our midst.

Ask ministry workers to work in teams. Remind them to use caution when arriving for meetings or practices in the evening. Make sure they utilize lights and don’t enter or exit the building alone.

A proper, proactive safety protocol for seniors and the disabled demands forethought from church leadership and should be discussed often. Review scenarios that could negatively impact them, such as alarms, fires, emergencies, bad weather, poorly lit exits, stairs, or even running and crawling children, who can be obstacles for the elderly and disabled.

In the kitchen, make sure that usage rules are posted or given to every person or group using the facility, including instructions for specialized kitchen equipment or tools.

Ushers should receive special training and instructions on how to handle those in walkers, wheelchairs, or using canes. Let them know exactly what their role is during an emergency.

Let members know that if they spot a hazard to identify it (make cones or signs available), fix it, or report it to prevent accidents.

Train staff and other volunteers as to what their response should be in the event of an incident, accident, or serious weather. Involve custodial and other volunteers to make sure that walks are clear, steps are free from hazards, and that designated helpers are available. Also, consider assigning a designated helper or guardian for those who need a little extra care while at church.

Staff should be trained on what scenarios might occur. In the emergency planning and response section, these issues and responses are detailed. Finally, training and communicating expectations to ushers can reduce potential incidents during worship. Seniors and the disabled In the event of an alarm sounding during a worship service, most parents will retrieve their children and others will exit the building, but seniors and those who are disabled will need assistance.


The key is to have a plan and let people know their specific role. People with special needs will be kept safer, and they will thank you for thinking of them. Office staff Ministries, with their outward focus, can forget to address staff issues. In many churches, staff members work alone inside the building during


the day with numerous doors unlocked, and numerous unknown persons coming and going. Staff members who work after dark can be in the unlocked church alone or walk into a dark parking lot without any protection. Depending on the location of your church, this can be a real concern.

Workers’ Compensations

Once again, communication is the key. Talk with your staff and discuss areas of vulnerability. Find ways to protect your staff, especially when they are in the building alone. Determine if it is wise to allow workers to work alone during the day or after hours. If you decide to allow it, consider locking low-use doors.

While it is difficult to provide specific instructions due to varying state guidelines, the following established principles can make your church a better place to work.

Workers’ compensation laws and insurance coverage varies from state to state and can be confusing. Regardless of your state laws, workers at your church deserve to work in a safe and healthy environment.

State and federal laws Make sure you are in compliance with state and federal laws. Tax-exempt, nonprofit entities are An inexpensive video camera at unlocked doors not automatically exempt from all compliance. Each state has a division that addresses worker with a monitor in the office will help office staff issues for each type of organization. Complete know who is entering and exiting the building. the necessary paperwork, obtain the necessary An intercom and electronic release system on certificates, and follow protocol when dealing the door can deter intruders there to do harm. with the laws and regulations involving accidents and injuries on the job. Also, work with The more soft barriers (windows, cameras, counters, etc.) and hard barriers (locked doors, your workers’ compensation carrier and agent. electronic releases, etc.) you have, the safer Work areas your staff will be. Make your inspection practices intentional. Finally, should someone enter the church to do Check for bad or dangerous work conditions. Look at the tools of the trade for each worker harm or commit a crime, it is wise to discuss a response in advance. It is better not to confront and make sure that they are clean, in good repair, and have the safeguards in place the person. If they are there to steal, give them (especially electrical and power tools). Look at the cash or items they want. However, if they ladders, lifts, and scaffolding to make sure they are there to attack, discuss alternatives. Meet are safe. Look for space heaters, fans, or other with a local police officer to discuss the best electrical appliances. Make sure that there are tactics to use in case of an assault. not too many items plugged into one outlet. Communicating issues, concerns, and safe practices and training are all ways of telling your staff, seniors, children, and members that you care.


Job descriptions The importance of good, complete job descriptions cannot be over-emphasized, not only for performance of duties, but also for comparison and evaluation of safe working conditions. Also, it is important to have job descriptions to determine if a person applying for a job is able to do the work necessary to fulfill the requirements. Reporting Have a method and procedure for reporting and addressing concerns. Accidents and incidents should be documented and reported to the proper church representative and to the necessary authorities. Reported hazards should be corrected immediately or clearly marked. Written safe practices and procedures All employment practices should be in writing. In case of a claim or injury, such guidelines are valuable in determining fault. Unfortunately, recent litigation history shows that churches are not exempt from employees filing claims or lawsuits. Ergonomic evaluations The number of repetitive motion claims and injuries from sitting and lifting are growing. Make sure that workstations are set up correctly; train workers on proper posture and equipment use; and rotate work that is continuous and repetitive. Designate lifting limits.


Training schedules Many accidents could be prevented by conducting proper training. Be sure that training sessions are periodically scheduled and attended by all involved parties. Keep attendance records in your file. Supervision Every workplace should have a designated supervisor in charge. That person is responsible to ensure that everyone is working to their potential, following prescribed guidelines and being adequately protected. Proper equipment, in-place procedures, and appropriate follow-up are necessary in maintaining a long-term, safe environment for everyone. These practices not only protect people, but also the ministry.

Property protection | 39

SECTION IX

Property protection

Overview Churches regularly experience the loss of property, cash, and equipment. This loss may be a result of a fire, a robbery or vandalism. Some churches are targeted because of their public stance on a particular issue. For all of these reasons, church leaders should consider methods of protecting their facilities and resources. In this section we offer a variety of fact sheets checklists, and information on the key topics that can and do impact churches. We will also share strategies and methods to be considered to prevent or reduce the likelihood of an incident occurring. People who choose to rob, destroy, or violate our space can sometimes succeed in spite of our best efforts. By discussing a strategy, implementing a plan, and following through, it is likely you will be putting barriers in place thwarting a would-be criminal’s intention of choosing your facility and congregation to victimize. As has been said in several other sections in this resource, one of the best ways to guarantee continuity and success in safeguarding your people, resources, and facilities is to organize a church safety and security team to provide oversight and direction. Monitored alarm systems A monitored alarm system can seem like a costly luxury when common sense precautions would seem to be enough. However, common sense precautions, procedures and even having someone present in the building are not enough to prevent fire, illegal entry, or theft. The key to minimizing damage is the ability to respond quickly, and monitored alarm systems can make the difference.

We highly recommend the training tool Fire Safety At Your Worship Center. This can be found online at: agfinancial.org/ rmresources.


The barrier for many churches is cost but consider the potential financial impact of even one event. Insurance coverage is sometimes adequate to cover what was lost from a fire or theft, but such events can incur additional costs that are often overlooked, such as the cost of meeting in another location for a year. Add to that the emotional trauma and loss of property, and a monitored alarm system seems less like a luxury and more like a necessity. Consider having a qualified alarm company provide an analysis and quote for a monitored fire/smoke/water/security system, and shop around. Most insurance carriers can recommend a company. Then find a way to build in the acquisition cost over the next several years. Sometimes, a church member is willing to underwrite part or even all of the installation. Access issues Church leaders need to reevaluate if it is truly appropriate for every person, present and past, to have access to the church at any time. Over time, churches using keys for entry are more vulnerable, not only to persons off the street, but also to former members, and in cases of lost or stolen keys. Sadly, many pastors and leaders hesitate to change systems for fear of offending or upsetting individual members. The good news is, access systems are improving in quality, and prices are dropping.


Access Ask church members, “Who has access to your church?” and the answer is often, “Everyone!” While it can be convenient for church members and staff to have unencumbered access as they conduct church business, many churches are reconsidering leaving the entire church facility open at all times to all people. Consider several facts: • Church facilities are increasingly the

target of theft. Many times, no forced entry is detected. • More incidents by disgruntled members

or former employees are taking place in churches. • Churches experience break-ins,

vandalism, or arson like any other business. • Many homeless seek shelter at night in

church buildings. • Churches have a wide selection of

equipment that thieves can steal and sell.

Property protection | 41

Proximity readers Proximity readers, a card, fob, or other small device waived in front of a small unit by the door (interior or exterior) releases the door for several seconds, allowing entry to a location, are a versatile, secure option. These programmable units also can limit access to certain doors and areas of the church. When a member leaves or no longer has a need for access, instead of trying to collect a key, the card is deactivated. Further, the arrivals and departures of cardholders can be monitored, which is helpful in the event of a theft or other incident. Keypad systems Another option is a keypad system, which grants access by code, which can be changed as needed. One drawback of keypad systems (versus proximity readers) is the requirement to memorize a set of numbers. Records and data Even well-intentioned churches that have emergency hard copies and an electronic copy of data, forget to back up all historical membership and financial information, which in a fire could be destroyed. With advances in technology, many options are available. These and other methods are important to protect important records, such as historical church documents, generational membership histories, and tithing records. It is not enough to have an inventory of church property onsite, as it can be destroyed in a fire. Backing up and storing data off-site is essential to the continuity of your ministry.

USB Drive You should routinely back up important records on a flash drive or server. Data that is stored on an external drive should be taken off premises and kept in a safe place (such as a safety deposit box). Off-site There are companies (much like a storage unit) that will house your important data for you, where you can conveniently update and retrieve data at your convenience.

The plan Most property and equipment can be replaced with much time and effort. When tragedy strikes, people need to come together for healing and mutual support. Time spent trying to determine what was in the church, how it could have caught fire, who left the door unlocked, and regretting inadequate planning for such events distract from the work that God has called you to do. Put a property-protection plan in place and follow through. You will be glad you did.


Contents evaluations

and look behind doors. Simply make a note of what room you are in and note everything in that room. That does not necessarily mean you need Much to the dismay of church leaders and insurance personnel, often, after a fire or theft, to count every pencil and paper clip. A general description of what is in the room, along with leaders are not able to accurately determine just what property was in the church building. a specific description of equipment, property, furniture, artwork, and valuables should be They are forced to rely on volunteers and specifically noted. Count chairs and tables, and members to compile a list. Such an effort put numbers to items such as robes, hymnals and takes time and is seldom accurate. bibles. This is not the time to estimate the value of items. Those doing the inventory should simply However, after a tragedy, some churches are be making notes (see Church Inventory List in able to quickly produce an accurate list of the Appendix). The valuation comes later. church contents, along with age and purchase price. Sometimes the church even has a picture Once the process is completed, leaders should or video. This aids with claims handling and allows the church to move forward with replacing then decide which items need additional information. Obviously, crayons and glue don’t lost items. need a value, but a soundboard, camera, piece of art, stained glass window, communion set, and The difference between these two scenarios pipe organ should be valued. It is helpful to place is intentionality. The second church scenario an approximate age on the item and, if known, realizes the importance of knowing what they a cost. Also, have those involved in oversight have and have taken steps to make sure they of specific areas (such as library, music files, have an accurate accounting of what they own. children’s area, etc.) provide an accurate count If you do not have a clear and current list of what and description of the items under their care. For extremely valuable items, an appraiser may need is in your facility, now is the time to become to make a dollar determination. Such appraisals intentional. How do you proceed? There are a can be quite valuable, both for making sure there variety of ways. First, you might approach the is adequate insurance coverage on the item women’s or men’s group. You could ask several and to determine what measures are needed to couples if they might be willing to spend a few protect the item. days at the church to help compile an inventory. Solicit one of the youth to videotape a leader as he/she describes the items. Use a combination of Finally, after this is completed, make a copy of the documents and store a copy off-site. Off-site approaches. The key is to have some record you is important in the event of a fire. It is important to can refer to should something tragic happen. make sure any equipment additions or deletions are noted on the list. The entire inventory should Produce documentation of everything in the be reviewed annually to maintain its accuracy. facility. That means every room, closet, storage area, office, worship area, library, and boiler room should be surveyed. Open cupboards, closets,


Insurance matters | 43

SECTION X

Insurance matters

Your church, its assets, and its members are the essential components of your ministry. Every effort should be taken to make sure that all are adequately protected. Though not a substitute for good risk management and safety and security safeguards, insurance is a valuable tool and should be understood by the church leadership. Furthermore, developing a positive, open relationship with your insurance agent is critical in determining your current and ongoing needs. They are in the best position to clarify coverage, help you understand terminology, and keep your ministries protected. Property coverage This coverage provides protection for your buildings and property. Areas of protection would include lightning, fire, vandalism, hail, explosions, etc. Personal property is often underinsured. Therefore when a loss occurs, coverage may not be complete. That’s why having an updated inventory list with values attached to each property item is important.

Additional property coverage (Always check with your insurance agent.) Water damage Coverage is available for floods and sewer backup. Employee dishonesty/treasury bond Various limits are available. Limited law and ordinance enforcement coverage This extends coverage to three areas: The value of the undamaged portion of building that requires demolition; the expense attached to the demolition and removal of the undamaged portion; and the increased cost of construction that may arise from a more costly construction standard due to changes in laws and ordinances. Pastor’s business or personal property Most policies cover the pastor’s businessrelated property. Some will include their non-business personal property at the parsonage or rented dwelling. Check with your agent. Limited building and personal property Limited coverage on property that is away from the church premises. However, some property may need to be covered on a separate inland marine floater. Systems and equipment breakdown coverage While property policies will cover such things as fire, explosions, etc., most will not cover systems if they break down. This coverage can be used to insure against breakdown replacement or repairs.


Liability coverage In recent years churches have become much more liable to lawsuits and claims. It is important to have coverage in the event a claim is made against your ministry.

General liability Optional endorsements are available for a wide variety of risks. Your agent should clearly understand your ministries so the proper coverage can be obtained. (Below are some of the available coverages) Sexual misconduct coverage Not only is it wise to have coverage for a real incident but also to defend against an allegation. Some insurers will require additional standards to be met to receive higher coverage limits. Directors’ and officers’ coverage This is coverage for decisions made by your board/officers/trustees. Employment practices liability This endorsement provides coverage for claims arising from practices associated with employmentrelated events. Counseling acts liability (non-fee-based and fee-based) Pastors and counselors are sometimes accused of physical and emotional harm. This endorsement would provide coverage. Excess liability (Umbrella) This is an added coverage that acts as an umbrella over your other liability coverages should those coverage limits be reached through claims experience. Pastor’s personal liability Should the pastor and/or his or her family be involved in a claim event away from church property, this endorsement would provide coverage. Foreign liability and foreign travel insurance If your church is involved in travel outside the continental United States, there may be limits on your basic coverage. Check with your agent to see if this coverage is needed. Workers’ compensation Each state has its own version of workers’ compensation laws and coverage. Your agent should be contacted to see which coverages and limitations are required in your state.


Insurance matters | 45

Business auto If a church owns its own vehicles, coverage is necessary. Also, all churches should have hired and non-owned auto liability coverage. If anyone runs errands for the church (i.e. getting the mail, picking up supplies, etc.) the church can be held responsible because the driver was operating on behalf of the church. The cost is minimal and every church has this risk. Some insurance providers have limitations both on vehicles and drivers. Check with your agent. Other coverage options There are other coverage options available depending on the level of need and activity your church is involved in. The key is to maintain a good relationship with your agent and keep lines of communication open should you have questions regarding your coverage. Also, if you engage in a new ministry, add a new building or room, or obtain a piece of equipment, contact your insurance professional so your policy can be reviewed for sufficient coverage.


Risk management completion summary sheet Congratulations! Having read the preceding pages, you now have a basic knowledge regarding risk management for your ministry. You are on your way to a safer and more secure future. At this point, it is important to recognize that knowledge is only half the battle. Without implementation you have not increased your church’s protection. By applying this information into a specific, committed ministry of your church, we believe you will see a reduction of accidents and claims, and your church will be solidly prepared to respond to challenges and opportunities. This next section will guide you as you move forward with implementation of what you have learned. Once the checklists for each section are complete (see Appendix) and deficiencies corrected, you will be ready to complete the Risk Management Guide completion checklist on page 47. Upon receipt of your completed checklist to our office, we will send you a certificate of completion recognizing your accomplishments.

Please forward the completion checklist to: AG Financial Insurance Solutions Risk Management Division PO Box 10263 Springfield, MO 65808-0263


RISK MANAGEMENT GUIDE COMPLETION CHECKLIST

Read Section Materials

Section

I. General RM Practices

Completed Checklist

Corrected Deficiencies

N/A

N/A

II. Safety and Security Team Development III. Child/Youth Sexual Misconduct IV. Transportation V. Facility Inspection and Maintenance VI. Financial VII. Emergency Preparation VIII. Personal Safety IX. Property Protection X. Insurance

I affirm that all sections, checklists and deficiencies have been addressed, corrected or commented on. ___________________________________________________________________________________ Name

Title

Date

Please indicate where to send the “Certificate of Completion” ______________________________________

______________________________________

Church Name

Attention

___________________________________________________________________________________ Address

City

State

Zip

______________________________________

______________________________________

Phone Number

E-mail Address

Send Completed Checklist to:

AG Financial Insurance Solutions Risk Management Department PO Box 10263 Springfield, MO 65808-0263

A resource of AG Financial Insurance Solutions.


Discretion will protect you, and understanding will guard you. Proverbs 2:11 (Niv)


Appendix

Appendix | 49

Appendix: forms Section II Establishing a church safety and security team Employment Application Background Referencing Checklist Personal Reference Check Form Employment Reference Check Form Volunteer Application Section III Child/youth sexual misconduct practices and procedures Sexual Misconduct Practices and Procedures Checklist Section IV

Transportation practices and procedures Driver Application Driver Release Form Driver Review and Training Checklist Motor Vehicle Accident Report Pre-Trip Safety Briefing Vehicle Inspection and Maintenance Form Church Transportation Program Checklist

Section V Facility inspection, maintenance, and usage Facilities Use Agreement Vendor Agreement Use of Premises Information Church Usage Updated Contact and Usage Description Information Church Interior Self-Inspection Checklist Church Exterior Self-Inspection Checklist Section VI Financial protection practices and procedures Financial Safeguard Questionnaire Offering/Counter’s Sheet Section VII Emergency preparation practices and procedures Disaster/Emergency Preparedness Kit Emergency Contact Emergency Preparation Checklist Section VIII Personal safety and security Personal Safety and Security Checklist Activity Participation Agreement Parental Permission and Medical Consent Section IX

Property protection Church Inventory List

Any and all information contained herein is distributed for general information purposes only. You should not rely upon the information herein as a basis for making any business, legal or any other decisions. AG Financial Insurance Solutions, LLC, (“AGFIS”) shall not be liable for any false, inaccurate, inappropriate or incomplete information presented and will not accept any liability in respect to the content. To the extent not prohibited by law, in no circumstances shall AGFIS be liable to you or any other third parties for any loss, damage (including, without limitation, damage for loss of business or loss of profits), or any other liability arising directly or indirectly from your use of or inability to use, the information contained herein.

Section II Establishing a church safety and security team

EMPLOYMENT APPLICATION Church Information ____________________________________________________ Name of Church

____________________________________________________ Name of Senior Pastor

_________________________________________________________________________________________________________________________ Church Address City State Zip

Confidential Information This application contains information that is confidential and may be reviewed only by the senior pastor listed above, the board of directors, or persons or committees authorized by the board of directors having authority to make personnel decisions regarding employees. Persons who review, duplicate, distribute, or disclose any portion of this document without authorization face one or more of the following consequences: (1) Possible criminal liability, (2) Possible civil liability, (3) Possible termination of employment, if an employee, (4) Possible dismissal from any official position within the church, if a volunteer.

Applicant Information ___________________________________________________ Name of Applicant

____________________________________________________ Position Applied For Date


EMPLOYMENT APPLICATION Please note that if the position you are applying for includes transporting minors, you may be asked to complete additional forms.

Applicant Information ____________________________________________________ Position Applied For _________________________________________________________________________________________________________________________ First Name Middle Name Last Name _________________________________________________________________________________________________________________________ Address City State Zip ____________________________________________________ Social Security Number

____________________________________________________ E-mail Address

____________________________________________________ Home Phone Number

____________________________________________________ Cell Phone Number

____________________________________________________ Length of time at current address*

*If less than five years, please list previous addresses for the last five years: _________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________

Are you 18 years or older?

Yes

No

Note: Conviction of a crime and/or answering yes to any of the following questions may not necessarily disqualify you for a position as an employee.

Have you ever been convicted of, pled guilty or no contest to a crime other than a minor traffic violation? If yes, please explain, including the name of the crime(s), the date and disposition of the case(s):

Yes

No

_________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________

Are you presently facing charges for any criminal offense? If yes, please explain:

Yes

No

_________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________

Have you ever been accused of or charged with any offense involving children? If yes, please explain, including disposition or current status of the charge:

Yes

No

_________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________


References Please list three (3) personal references. Your reference must have the ability to assess your suitability for working with or around minors. Please do not include relatives.

Reference One ____________________________________________________ Name

____________________________________________________ Years Known

_________________________________________________________________________________________________________________________ Address City State Zip ____________________________________________________ Phone Number

____________________________________________________ E-mail Address

Reference Two ____________________________________________________ Name

____________________________________________________ Years Known


____________________________________________________ E-mail Address

Reference Three ____________________________________________________ Name

____________________________________________________ Years Known


____________________________________________________ E-mail Address

Citizenship Are you a citizen of the United States?

Yes

No

If No, are you a legal alien authorized to work in the United States?

Yes

No

Education Please check last grade completed: 1

Years of College:

2

Years of Graduate School:

8 3

1

9

10

11

12

GED

4 2

3

4

Please provide the following information about the schools you ve attended. Note: In considering your application, the church may require an official transcript from one or more schools attended.

School One ____________________________________________________ Name

____________________________________________________ Dates Attended

_________________________________________________________________________________________________________________________ Address City State Zip ____________________________________________________ Major Did you graduate?

Yes

____________________________________________________ Degree

No A resource of AG Financial Insurance Solutions.

School Two ____________________________________________________ Name

____________________________________________________ Dates Attended


Yes

____________________________________________________ Degree

No

School Three ____________________________________________________ Name

____________________________________________________ Dates Attended


Yes

____________________________________________________ Degree

No

Training & Experience Please list any relevant training or experience you have including any professional license(s) or certification(s): _________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________

Employment History Please list your employers for the past five (5) years, or last three (3) employers, whichever list is longer, beginning with your current or most recent employer. Please note any periods of time in which you were not employed.

Employer One ____________________________________________________ Name

____________________________________________________ Position

_________________________________________________________________________________________________________________________ Address City State Zip ____________________________________________________ Start Date/Ending Date (Month/Year)

____________________________________________________ Ending Salary or Hourly Rate

____________________________________________________ Supervisor Name & Title

____________________________________________________ Supervisor Phone Number

_________________________________________________________________________________________________________________________ Reason for Leaving Description of Duties: _________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________


Employer Two ____________________________________________________ Name

____________________________________________________ Position






Employer Three ____________________________________________________ Name

____________________________________________________ Position






Employer Four ____________________________________________________ Name

____________________________________________________ Position





_________________________________________________________________________________________________________________________ Reason for Leaving


Description of Duties: _________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________

Have you ever been dismissed, terminated or forced to resign for any reason from any employment? If yes, please explain:

Yes

No

_________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________

Church Membership Are you currently a member of a church? If yes, please provide the following:

Yes

____________________________________________________ Church Name

No ____________________________________________________ Name of Pastor

_________________________________________________________________________________________________________________________ Address City State Zip ____________________________________________________ Years Attended

Church Attendance If you have not been a member of or have not attended your current church for the last five (5) years, please list where you have attended church beginning with the most recent church. Please note any periods of time in which you did not attend.

Church One ____________________________________________________ Name

____________________________________________________ Phone Number

_________________________________________________________________________________________________________________________ Address City State Zip ____________________________________________________ Dates Attended (Month/Year)

Where you a member?

Yes

No

Church Two ____________________________________________________ Name

____________________________________________________ Phone Number

_________________________________________________________________________________________________________________________ Address City State Zip ____________________________________________________ Dates Attended (Month/Year)

Where you a member?

Yes

No


Additional Information Please list any other additional information that you believe may be useful in evaluating your Employment Application. Examples may include special training programs in which you participated in or experience not reflected above. _________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________

Application Agreement In completing this Employment Application, I understand, represent and agree that: 1. Acceptance of this completed Application by the Church listed below, does not mean that an employment position for which I am qualified, is open or that the church has agreed to provide me with employment. The Church is under no obligation to offer me employment as the result of accepting my completed application. 2. As part of the Church s procedure for verifying the information provided by me on this form or evaluating me for employment purposes, the Church may contact persons, employers and/or organizations named by me in this form; conduct a national criminal background check; conduct a sex offender registry check; a social security trace or other appropriate background investigative report which may include information gathered through personal interviews with third parties, family members, and persons, with whom I am acquainted. I consent to the Church making such checks and understand that this may include information regarding my character, general reputation, and personal characteristics. I further agree to sign any and all documents, consents and/or agreements which may be necessary for the Church and its authorized representatives and/or designees to complete the above. By signing this form, I authorize the Church to request and obtain the information described above. Further, I release the Church and its denominational agency, affiliates, related entities, agents, employees, and officers (collectively “Church”) and all references from any claim or liability whatsoever arising out of such request or any information disclosed in response thereto, and I agree to hold the Church and all references harmless and will not to bring any action or assert any claim against the Church or any reference on account thereof. Applicant s initials _________ 3. I understand that providing false or misleading information or failure to state material facts either in this form or in any interview will result in the immediate rejection of my application for employment with the Church or immediate dismissal if such false or misleading information is discovered after any employment offer from the Church is accepted by me.

I have read and understand the above and affirm that the information I have provided on this application is true and correct. ____________________________________________________ Name of Church ____________________________________________________ Printed Name of Applicant

____________________________________________________ Signature of Applicant Date

Note: A photocopy or facsimile of this authorization shall be as valid as the original.


Request for Background Information _________________________________________________________________________________________________________________________ First Name of Applicant Middle Name Last Name _________________________________________________________________________________________________________________________ Maiden Name or Other Names Used ____________________________________________________ Social Security Number

____________________________________________________ Date of Birth

____________________________________________________ Driver s License Number

____________________________________________________ State Issued

Have you ever been convicted of a felony or misdemeanor?

Yes

No

Background Verification & Disclosure As part of the pre-employment process the Church listed below may obtain a Consumer Report and/or Investigative Consumer Report that may include legally obtainable criminal records. The Fair Credit Reporting Act as amended by the Consumer Reporting Reform Act of 1996 requires that we advise you that for purposes of employment only, a Consumer Report may be made which may include information about your credit standing, character, general reputation, personal characteristics, or mode of living. Upon written request, additional information as to the nature and scope of the report, if one is made, will be provided, in the event the Report contains information regarding your character, general reputation, personal characteristics, criminal history or mode of living.

Authorization to Release Information During the application process and at any time during any subsequent employment, I authorize the Church to procure a Consumer Report which I understand may include information regarding my credit standing, character, general reputation, personal characteristics, criminal history, or mode of living. This report may be compiled with information from credit bureaus, court record repositories, departments of motor vehicles, past or present employers and educational institutions, governmental occupational licensing or registration entities, business or personal references, and any other source required to verify information that I have voluntarily supplied. I understand that I may request a complete and accurate disclosure of the nature and scope of the background verification; to the extent such investigation includes information bearing on my character, general reputation, personal characteristics, criminal history or mode of living. ____________________________________________________ Name of Church ____________________________________________________ Printed Name of Applicant


____________________________________________________ Printed Name of Witness

____________________________________________________ Signature of Witness Date


Background Referencing Checklist To be completed by the Church. ____________________________________________________ Name of Church

____________________________________________________ Name of Applicant

____________________________________________________ Name of Person Completing Referencing

____________________________________________________ Signature of Person Completing Referencing

Current/Last Employer ____________________________________________________ Name

____________________________________________________ Referencing Method

Written Reference Form Returned?

Phone Interview Form Completed?

Yes

No

Yes

No

Past Employer ____________________________________________________ Name




Yes

No

Yes

No

Past Employer ____________________________________________________ Name




Yes

No

Yes

No

Personal Reference ____________________________________________________ Name




Yes

No

Yes

No





Yes

No

Yes

No





Yes

No

Yes

No

Background Screening Check ____________________________________________________ Name of Person Requesting Background Screening Check

____________________ Date Requested

____________________ Date Returned


Personal Reference Check Complete a form for each Personal Reference listed by the Applicant. ____________________________________________________ Name of Church _________________________________________________________________________________________________________________________ Address City State Zip ____________________________________________________ Name of Applicant

____________________________________________________ Position Applied For

____________________________________________________ Name of Reference

____________________________________________________ Date Completed

Completed By:

Phone

Mail

1. How do you know the applicant? _________________________________________________________________________________________________________________________

2. How long have you known the applicant? ____________________ 3. Have you seen the applicant work with children?

Yes

No

4. What is your assessment of the applicant s fitness and suitability for working with children? _________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________

5. Do you have any reservations regarding the applicant s fitness and suitability for working with children? _________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________

6. What type of recommendation would you give the applicant? _________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________

7. Do you have any other information regarding the applicant s fitness and suitability for working with children which would be helpful to the Church listed above? _________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________

INTERNAL CHURCH USE ONLY: ____________________________________________________ Name of Person Completing Referencing

____________________________________________________ Signature of Person Completing Referencing Date A resource of AG Financial Insurance Solutions.

Employment Reference Check Complete a form for each Employer listed by the Applicant. ____________________________________________________ Name of Church _________________________________________________________________________________________________________________________ Address City State Zip ____________________________________________________ Name of Applicant

____________________________________________________ Position Applied For

____________________________________________________ Name of Reference

____________________________________________________ Date Completed

Completed By:

Phone

Mail

1. How do you know the applicant? _________________________________________________________________________________________________________________________

2. What was your relationship with the applicant during the period of employment? _________________________________________________________________________________________________________________________

3. Were the applicant s duties performed satisfactorily? If not, please explain:

Yes

No

_________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________

4. Why did the applicant leave your organization? _________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________

5. Have you seen the applicant work with children?

Yes

No

6. What is your assessment of the applicant s fitness and suitability for working with children? _________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________

7. Do you have any reservations regarding the applicant s fitness and suitability for working with children? _________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________

8. What type of recommendation would you give the applicant? _________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________

9. Do you have any other information regarding the applicant s fitness and suitability for working with children which would be helpful to the Church listed above? _________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________

INTERNAL CHURCH USE ONLY: ____________________________________________________ Name of Person Completing Referencing

____________________________________________________ Signature of Person Completing Referencing Date


VOLUNTEER APPLICATION FOR THOSE WORKING WITH MINORS Church Information ____________________________________________________ Name of Church

____________________________________________________ Name of Senior Pastor

_________________________________________________________________________________________________________________________ Church Address City State Zip

Confidential Information This application contains information that is confidential and may be reviewed only by the senior pastor listed above, the board of directors, or persons or committees authorized by the board of directors having authority to make personnel decisions regarding employees. Persons who review, duplicate, distribute, or disclose any portion of this document without authorization face one or more of the following consequences: (1) Possible criminal liability, (2) Possible civil liability, (3) Possible termination of employment, if an employee, (4) Possible dismissal from any official position within the Church, if a volunteer.

Applicant Information ____________________________________________________ Name of Applicant

____________________________________________________ Position Applied For Date


VOLUNTEER APPLICATION Please note that if the position you are applying for includes transporting minors, you may be asked to complete additional forms.

Applicant Information _________________________________________________________________________________________________________________________ First Name Middle Name Last Name _________________________________________________________________________________________________________________________ Address City State Zip ____________________________________________________ Phone Number

____________________________________________________ E-mail Address

____________________________________________________ Occupation

Are you 18 years or older?

Yes

No

(Parental or Guardian Consent is required if less than 18.) Note: Conviction of a crime and/or answering yes to any of the following questions may not necessarily disqualify you for a position as an employee.

Have you ever been convicted of, pled guilty or no contest to a crime other than a minor traffic violation? If yes, please explain, including the name of the crime(s), the date and disposition of the case(s):

Yes

No

_________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________

Are you presently facing charges for any criminal offense? If yes, please explain:

Yes

No

_________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________

Have you ever been accused of or charged with any offense involving children? If yes, please explain, including disposition or current status of the charge:

Yes

No

_________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________

Church Involvement Have you ever interviewed to be a volunteer at the Church listed above prior to today s date? If yes, please give the date(s) and interviewer s name:

Yes

No

_________________________________________________________________________________________________________________________

Are you currently a member of a church? If yes, please provide the following:

Yes

____________________________________________________ Church Name

No

____________________________________________________ Name of Pastor

_________________________________________________________________________________________________________________________ Address City State Zip ____________________________________________________ Years Attended A resource of AG Financial Insurance Solutions.

Education Please check last grade completed: Years of College:

1

Years of Graduate School:

2

8 3

1

9

10

11

12

GED

4 2

3

4

References Please list three (3) personal references. Your references must have the ability to assess your suitability for working with or around minors. Two (2) references must be members of this Church; one (1) reference should be from a current or past position in which you volunteered or worked with children from someone who works with children on a regular basis. Please do not include relatives.


____________________________________________________ Relationship to You


____________________________________________________ E-mail Address




____________________________________________________ E-mail Address

Reference Three ____________________________________________________ Name



____________________________________________________ E-mail Address

Experience Working with Children Please list up to three of your previous experiences where you worked with children beginning with your current or most recent. Note: If you have less than three prior experiences, please list all that you have.

If you have no prior experience, please state “none” here: ____________________

Previous Experience One ____________________________________________________ Church/Organization Name

____________________________________________________ Position

_________________________________________________________________________________________________________________________ Address City State Zip


____________________________________________________ Start Date/Ending Date (Month/Year) ____________________________________________________ Supervisor Name & Title



Previous Experience Two ____________________________________________________ Church/Organization Name

____________________________________________________ Position

_________________________________________________________________________________________________________________________ Address City State Zip ____________________________________________________ Start Date/Ending Date (Month/Year) ____________________________________________________ Supervisor Name & Title



Previous Experience Three ____________________________________________________ Church/Organization Name

____________________________________________________ Position

_________________________________________________________________________________________________________________________ Address City State Zip ____________________________________________________ Start Date/Ending Date (Month/Year) ____________________________________________________ Supervisor Name & Title




Applicant s Statement Please write a brief statement explaining why you are seeking a volunteer position with this Church and describe why you want to work with children and would make a good volunteer for this Church. _________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________

Volunteer Agreement In completing this Volunteer Application, I understand, represent and agree that: Acceptance of this completed Application by the Church listed below does not mean that a volunteer position for which I am qualified, is open or that the Church has agreed to allow me to volunteer. Church is under no obligation to utilize my services as the result of accepting this completed application. As part of the Church s procedure for verifying the information provided by me on this form or evaluating me for volunteer purposes, the Church may contact persons, employers and/or organizations named by me in this form; conduct a national criminal background check; conduct a sex offender registry check; a social security trace or other appropriate background investigative reports which may include information gathered through personal interviews with third parties, family members, and persons, with whom I am acquainted. I consent to the Church making such checks and understand that this may include information regarding my character, general reputation, and personal characteristics. I further agree to sign any and all documents, consents and/or agreements which may be necessary for the Church and its authorized representatives and/or designees to complete the above. By signing this form, I authorize Church to request and obtain the information described above. Further, I release Church and its denominational agency, affiliates, related entities, agents, employees, and officers (collectively “Church”) and all references from any claim or liability whatsoever arising out of such request or any information disclosed in response thereto, and I agree to hold the Church and all references harmless and will not to bring any action or assert any claim against the Church or any reference on account thereof. I understand that my providing of false or misleading material information or my failure to state material facts either in this form or in any interview will result in the immediate rejection of my application as a volunteer with or immediate dismissal if such false or misleading information is discovered after any volunteer offer is accepted by me from the Church listed above.

I have read and understand the above and affirm that the information I have provided on this application is true and correct. ____________________________________________________ Name of Church ____________________________________________________ Printed Name of Applicant


Note: A photocopy or facsimile of this authorization shall be as valid as the original.


Background Referencing Checklist To be completed by the Church. ____________________________________________________ Name of Church

____________________________________________________ Name of Applicant

____________________________________________________ Name of Person Completing Referencing

____________________________________________________ Signature of Person Completing Referencing

Current/Last Church or Organization ____________________________________________________ Name




Yes

No

Yes

No

Past Church or Organization ____________________________________________________ Name




Yes

No

Yes

No

Past Church or Organization ____________________________________________________ Name




Yes

No

Yes

No





Yes

No

Yes

No





Yes

No

Yes

No





Yes

No

Yes

No

Background Screening Check ____________________________________________________ Name of Person Requesting Background Screening Check

____________________ Date Requested

____________________ Date Returned


Section III Child/youth sexual misconduct

SEXUAL MISCONDUCT PRACTICES AND PROCEDURES CHECKLIST Used by permission from Christian Ministry Resources – Reducing the Risk 2, page 18.

The following general areas of concern should be assessed on a regular basis (quarterly or more often). If the answer to a question is “no,” comments and corrective action should be made.

Questions Are all employees and volunteers, including clergy, who work with youth or children screened?

Yes

No

_________________________________________________________________________________________________________________________ Comments/Actions Are reference checks completed on all employees and volunteers who work with youth or children?

Yes

No

_________________________________________________________________________________________________________________________ Comments/Actions Are all prospective employees interviewed before they are hired?

Yes

No

_________________________________________________________________________________________________________________________ Comments/Actions Are all volunteers interviewed before they begin working with youth or children?

Yes

No

_________________________________________________________________________________________________________________________ Comments/Actions Are all employees and volunteer workers who work with youth or children trained?

Yes

No

_________________________________________________________________________________________________________________________ Comments/Actions Are policies to prevent sexual abuse in place, taken seriously, and enforced?

Yes

No

_________________________________________________________________________________________________________________________ Comments/Actions Do workers understand state law concerning child abuse reporting obligations?

Yes

No

_________________________________________________________________________________________________________________________ Comments/Actions Our workers understand state law concerning child abuse reporting obligations.

Yes

No

_________________________________________________________________________________________________________________________ Comments/Actions Is there a clearly defined reporting procedure in place for a suspected incident of abuse?

Yes

No

_________________________________________________________________________________________________________________________ Comments/Actions Is there adequate insurance coverage if a claim should occur.

Yes

No

_________________________________________________________________________________________________________________________ Comments/Actions Is the Church prepared to respond to media inquiries if an incident of abuse should occur?

Yes

No

_________________________________________________________________________________________________________________________ Comments/Actions Are programs and policies reviewed on a regular basis and changes made where needed?

Yes

No

_________________________________________________________________________________________________________________________ Comments/Actions

I have completed this inspection and certify that the above checked items were checked and any concerns noted. ____________________________________________________ Printed Name

____________________________________________________ Signature Date A resource of AG Financial Insurance Solutions.

Section IV Transportation

DRIVER APPLICATION Applicant Information ____________________________________________________ Name

____________________________________________________ Date of Application

_________________________________________________________________________________________________________________________ Address City State Zip ____________________________________________________ Social Security Number

____________________________________________________ Date of Birth

____________________________________________________ Driver License Number

____________________________________________________ State Issued

Have you ever been refused a license (or suspended)?

Yes

No

In the last three years, have you ever been: Cited for DWI?

Yes

No

Involved in an auto accident?

Yes

No

Cited for speeding?

Yes

No

License suspended?

Yes

No

If you answered yes to any of the questions above, please provide details regarding the incident(s): _________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________

What type of vehicles have you been trained or certified to drive? _________________________________________________________________________________________________________________________

Do you have any special licenses to do so? If yes, please list:

Yes

No

_________________________________________________________________________________________________________________________

Is there any reason you should not work with or around youth or children? If yes, please explain:

Yes

No

_________________________________________________________________________________________________________________________

Please provide two references below. Please do not include relatives.


____________________________________________________ Years Known


____________________________________________________ E-mail Address



____________________________________________________ Years Known


____________________________________________________ E-mail Address

Will you give us your permission to run a motor vehicle records check and/or a criminal records check as needed? Yes No I affirm that all information provided here is accurate to the best of my knowledge. ____________________________________________________ Printed Name of Applicant


INTERNAL CHURCH USE ONLY: Application approved?

Yes

No

Passed driver s test?

Yes

No

____________________________________________________ Name of Person Reviewing Application

____________________________________________________ Signature of Person Reviewing Application Date


DRIVER RELEASE FORM Church Information ____________________________________________________ Name _________________________________________________________________________________________________________________________ Address City State Zip

Trip Information ____________________________________________________ Destination

____________________________________________________ Date of Trip

Insurance Information ____________________________________________________ Driver Name

____________________________________________________ Policy Holder Name

____________________________________________________ Auto Insurance Company

____________________________________________________ Policy Number

____________________________________________________ Effective Dates

____________________________________________________ Coverage (Min. 50/100 BI /50 PDF; prefer 100/300 BI /100 PD)

I will maintain my insurance at the approved specified.

Yes

No

If a change is made, I will notify the church listed above.

Yes

No

I have provided the church a copy of my auto insurance policy.

Yes

No

I will provide the church an updated copy when my insurance is renewed.

Yes

No

DMV Information ____________________________________________________ Driver License Number

____________________________________________________ CDL Expiration Date

I have provided the church a legible copy of my driver s license.

Yes

No

I am between the ages of 25 and 65.

Yes

No

I have signed and submitted the DMV “Employer Pull Notice” form* to the church. * (Authorization for Release of Driver Record Information)

Yes

No

Yes

No

In the last three years, I have been convicted of more than one minor traffic violation or had more than one at fault accident. If yes, please provide more details:

_________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________

Vehicle Safety Number of passengers with working seat belts in this vehicle: ____________________ As required by law, I guarantee that all occupants will be wearing seat belts while this vehicle is being operated and comply with the safety requirements of the vehicle including but not limited to airbags:

Yes

No


The automobile being driven for the specified trip is in good working operation, has been regularly maintained and inspected and I have no concerns regarding the safety of my vehicle:

Yes

No

I will caravan with the group (as applicable) and will keep in close contact with staff:

Yes

No

I affirm that the above information is accurate and correct and I will carry insurance on the vehicle being driven, and I will notify the church if my insurance is cancelled or if any of the above information changes. I will always operate this vehicle in safe manner while transporting. ____________________________________________________ Name of Driver

____________________________________________________ Signature of Driver Date

INTERNAL CHURCH USE ONLY: Approved for driving church vehicles:

Yes

No

Approved for driving on trips:

Yes

No

DMV record received:

Yes

No

Volunteer screened:

Yes

No

Driver contacted/confirmed:

Yes

No

____________________________________________________ Name of Person Transportation Director

____________________________________________________ Signature of Transportation Director Date


DRIVER REVIEW AND TRAINING CHECKLIST The following questions are designed to determine whether a driver should be renewed as a preferred driver. An annual review for each driver (of private and church-owned vehicles) is recommended. All “no” answers should be commented on or acted upon.

Questions Did the driver complete an application prior to being permitted to drive?

Yes

No

_________________________________________________________________________________________________________________________ Comments/Actions Was a motor vehicle records check completed on this driver?

Yes

No

_________________________________________________________________________________________________________________________ Comments/Actions Was a background check completed (for those transporting minors)?

Yes

No

_________________________________________________________________________________________________________________________ Comments/Actions Was the driver s insurance information verified?

Yes

No

_________________________________________________________________________________________________________________________ Comments/Actions Did this driver receive a basic safe driver s course prior to being permitted to drive?

Yes

No

_________________________________________________________________________________________________________________________ Comments/Actions Has the driver received any driver training since being hired?

Yes

No

_________________________________________________________________________________________________________________________ Comments/Actions Has the driver been trained on how to do a pre and post trip inspection and complete the form?

Yes

No

_________________________________________________________________________________________________________________________ Comments/Actions Has the driver been trained on all vehicles they have been asked to drive?

Yes

No

_________________________________________________________________________________________________________________________ Comments/Actions Has the driver been free of complaints since last review?

Yes

No

_________________________________________________________________________________________________________________________ Comments/Actions Has the driver been free of any personal or church-related accidents since last review?

Yes

No

_________________________________________________________________________________________________________________________ Comments/Actions Has the driver been free of any medical condition since the last review that may impact driving?

Yes

No

_________________________________________________________________________________________________________________________ Comments/Actions Is the driver between the ages of 25 and 65?

Yes

No

_________________________________________________________________________________________________________________________ Comments/Actions Should this driver be renewed another year?

Yes

No




MOTOR VEHICLE ACCIDENT REPORT To get better information in the event of an accident, the following information should be gathered as quickly as possible after an accident by the driver or other adult. A copy of this should be in every vehicle used in transporting. Complete as much information as possible.

Accident Information ____________________________________________________ Date

____________________________________________________ Time of Accident

_________________________________________________________________________________________________________________________ Address City State Zip ____________________________________________________ County

____________________________________________________ Mile Marker

_________________________________________________________________________________________________________________________ Landmarks

Vehicle One Information _________________________________________________________________________________________________________________________ Driver s First Name Middle Name Last Name _________________________________________________________________________________________________________________________ Address City State Zip ____________________________________________________ Home Phone Number

____________________________________________________ Work Phone Number

____________________________________________________ Date of Birth

____________________________________________________ Driver s License Number State Issued

_________________________________________________________________________________________________________________________ Vehicle Owner s First Name Middle Name Last Name _________________________________________________________________________________________________________________________ Address City State Zip ____________________________________________________ Year, Make and Model of Vehicle

____________________________________________________ License Plate Number State Issued

____________________________________________________ Name of Insurance Company

Vehicle Two (or Pedestrian) Information _________________________________________________________________________________________________________________________ Driver s First Name Middle Name Last Name _________________________________________________________________________________________________________________________ Address City State Zip ____________________________________________________ Home Phone Number

____________________________________________________ Work Phone Number

____________________________________________________ Date of Birth

____________________________________________________ Driver s License Number State Issued

_________________________________________________________________________________________________________________________ Vehicle Owner s First Name Middle Name Last Name _________________________________________________________________________________________________________________________ Address City State Zip ____________________________________________________ Year, Make and Model of Vehicle

____________________________________________________ License Plate Number State Issued

____________________________________________________ Name of Insurance Company A resource of AG Financial Insurance Solutions.

Accident Description To the best of your ability, briefly describe the details of the accident. _________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________

Accident Diagram To the best of your ability, sketch the locations of the vehicles/pedestrians. A.

B.

C.

D. (Draw)

Injured Persons List any persons claiming injuries

Person One ____________________________________________________ Name

____________________________________________________ Phone Number

_________________________________________________________________________________________________________________________ Address City State Zip _________________________________________________________________________________________________________________________ Injuries

Person Two ____________________________________________________ Name

____________________________________________________ Phone Number


Person Three ____________________________________________________ Name

____________________________________________________ Phone Number



Witnesses Locate witnesses immediately and obtain information.

Witness One ____________________________________________________ Name

____________________________________________________ Phone Number


Witness Two ____________________________________________________ Name

____________________________________________________ Phone Number


Witness Three ____________________________________________________ Name

____________________________________________________ Phone Number


Police Report Information Was a police report filed?

Yes

No

If yes, please provide the following: ____________________________________________________ Police Department Name

____________________________________________________ Officer s Name

_________________________________________________________________________________________________________________________ Address City State Zip ____________________________________________________ Police Department Phone Number


PRE-TRIP SAFETY BRIEFING The following is a checklist for drivers/leaders to communicate to the passengers of the trip. This list should be discussed with everyone, and each minor occupant should sign that they understand and will follow the guidelines. 1. The driver (or designated leader) is responsible for the trip and their instructions are to be followed at all times. 2. All occupants must wear their seatbelts at all times when the vehicle is moving. 3. Nothing hazardous may be brought inside the vehicle at any time. 4. All occupants should keep arms, legs, and other objects inside the vehicle at all times. 5. Excessive noise and loud music are not permitted. 6. Do not put anything in front of a window or in a position that will obstruct the view of the driver. 7. In the event of an accident or an emergency, follow the driver/leader s instruction. Exit the vehicle on the passenger (or curb) side of the vehicle only after instructed. 8. Violation of these rules may result in termination of the trip for the individual or the entire group. 9. Report any concerns or hazards you observe. 10. Aid and assist the driver(s) and others to make this a safe trip.

Minors Only I have read and understand these rules and affirm that I will follow them. ____________________________________________________ Name

____________________________________________________ Date


VEHICLE INSPECTION AND MAINTENANCE FORM FOR USE BY DRIVERS & TRANSPORTATION SUPERVISORS

The following form may be used for both church-owned vehicles and privately owned vehicles that will be used for longer trips. ____________________________________________________ Inspector s Name

____________________________________________________ Date of Inspection

____________________________________________________ Year, Make and Model of Vehicle

____________________________________________________ Current Mileage

Item Tires condition, tread, and pressure (plus wheels and lugs) Passed Failed

Brakes Passed

____________________________________________________ Action Needed or Taken


Gauges Passed

Heater/defroster Passed Failed

Failed

Failed



Air-conditioning Passed Failed

Fluid levels Passed



Windshield and windows Passed Failed

Mirrors (side and rear-view) Passed Failed



Shocks and struts Passed Failed

Battery Passed



Headlights, turn signals, and brake lights Passed Failed

Emergency kit (First-aid, flares/signs) Passed Failed



Body exterior Passed Failed

Wiper and washer condition and operation Passed Failed



Horn Passed

Belts and hoses Passed Failed

Failed

Failed

Failed



Recent lube, oil and filter Passed Failed

Muffler and exhaust system Passed Failed



Other: ____________________________ Passed Failed

Other: ____________________________ Passed Failed



Is this vehicle safe to use at this time?

Yes

No

____________________________________________________ Printed Name


CHURCH TRANSPORTATION PROGRAM CHECKLIST The following questions should be asked in relationship to any transportation activity in which your church engages. If the answer to a question is “no,” comments and corrective action should be taken and noted.

Questions Do we have a written transportation policy?

Yes

No

_________________________________________________________________________________________________________________________ Comments/Actions Is someone (or a committee) designated to oversee the transportation ministry?

Yes

No

_________________________________________________________________________________________________________________________ Comments/Actions Are all vehicles (both private and church-owned) inspected prior to every trip?

Yes

No

_________________________________________________________________________________________________________________________ Comments/Actions Do we have a list of pre-selected and approved drivers?

Yes

No

_________________________________________________________________________________________________________________________ Comments/Actions Are minors prevented from driving on church-sponsored trips?

Yes

No

_________________________________________________________________________________________________________________________ Comments/Actions Are motor vehicle records checks completed on all drivers?

Yes

No

_________________________________________________________________________________________________________________________ Comments/Actions For those driving private vehicles, is their insurance coverage verified?

Yes

No

_________________________________________________________________________________________________________________________ Comments/Actions Are pre- and post-trip vehicle inspections completed and documented?

Yes

No

_________________________________________________________________________________________________________________________ Comments/Actions For church-owned vehicles, is there a regular and documented maintenance schedule?

Yes

No

_________________________________________________________________________________________________________________________ Comments/Actions Are vehicles equipped with seatbelts and is their use required?

Yes

No

_________________________________________________________________________________________________________________________ Comments/Actions Is there an accident reporting form in every vehicle?

Yes

No

_________________________________________________________________________________________________________________________ Comments/Actions Is there a safety kit in every vehicle being taken on an extended trip?

Yes

No

_________________________________________________________________________________________________________________________ Comments/Actions Are phones or other communication devices available in each vehicle?

Yes

No



Are occupants given a safety briefing prior to taking extended trips?

Yes

No

_________________________________________________________________________________________________________________________ Comments/Actions Has the church confirmed with their insurance agent that they have adequate transportation coverage?

Yes

No

_________________________________________________________________________________________________________________________ Comments/Actions Is there up-to-date insurance information in every church-owned vehicle?

Yes

No

_________________________________________________________________________________________________________________________ Comments/Actions Have all drivers been adequately trained in all vehicles they will be driving?

Yes

No

_________________________________________________________________________________________________________________________ Comments/Actions Has the leadership been informed on the safety issues concerning 15-passenger vans and has alternative transportation been considered?

Yes

No

_________________________________________________________________________________________________________________________ Comments/Actions Are drivers transporting minors required to complete a background check?

Yes

No

_________________________________________________________________________________________________________________________ Comments/Actions Has the church checked with their insurance carrier to determine if they have specific driver, vehicle, and training requirements?

Yes

No



____________________________________________________ Signature Date


Section V Facility inspection, maintenance, and usage

FACILITIES USE AGREEMENT This Agreement is entered into this __________ day of __________, __________ by and between ____________________________________________________ Name of Church

and

________________________________________________ Licensee

of

_________________________________________________ . City & State of Licensee

In consideration of the mutual promises and conditions contained herein, Church and Licensee agree as follows:

1. Grant of License Church grants Licensee a license to use the premises as follow:

A. Description of Premises _________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________

B. Personal Property/Resources (if any) _________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________

C. Purpose(s) _________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________

D. Date(s) and Time(s) Term _________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________

2. Term of License This License shall be effective as of and continue through the dates and times described above. Licensee shall promptly vacate the premises at the end of the license term.

3. Payment Terms Licensee agrees to the following payment terms: A. Deposit. Upon execution of this Agreement, Licensee shall pay the Church a deposit representing one-half of the fee for the use of the Licensed Premises. Payment of the deposit shall reserve the premises and facilities for Licensee s use. Until such deposit actually received, the Church may offer and license the premises and facilities to other potential licensees. B. Final Bill. In the absence of an express billing arrangement to the contrary, Licensee shall be presented with and pay a final bill prior to Licensee s use of the premises. C. Sales Tax/Other Applicable Taxes. The final bill shall include all state applicable taxes. Any request for an exemption from the payment of sales tax must be accompanied, in advance, by proof of exemption.

4. Terms of Use Licensee agrees that its use of the premises and facilities is subject to the following terms and conditions: A. Licensee shall use only the premises and personal property/resources describe in paragraph one above, only for the purposes stated in this Agreement. Licensee shall not use any other Church property and resource and shall be responsible for any damages caused by the unauthorized use of such property or resource. B. Licensee shall comply with all Church policies, rules and regulations. C. Licensee shall comply with all applicable municipal, county, state and federal laws and regulations. D. Licensee shall place no signs or temporary structure on the premises without obtaining advance written approval from Church. Any signs or temporary structures placed on the premises by Licensee shall be promptly removed at the end of the license term. E. Licensee shall not create any nuisance or disturb the quiet enjoyment of anyone utilizing adjacent or common premises and facilities. F. Licensee expressly acknowledges that the sale, possession, consumption and use of alcoholic beverages, tobacco, and illegal drugs are forbidden on all Church premises. A resource of AG Financial Insurance Solutions.

G. Licensee expressly acknowledges that the use and possession of weapons and firearms are forbidden on all Church Premises. H. In the event Licensee s use of the premises and facilities involves participants who are minors (including the minor children of participants), then Licensee shall be responsible for the safety of all such minors and shall place such minors under the constant supervision and control of a responsible adult. Licensee shall be responsible for conducting suitable and thorough background checks on all persons supervising minor children. Licensee shall further be responsible for obtaining a properly completed and signed Authorization from the custodial parent(s) of any minor child who will participate in Licensee s use of the premises and facilities without the presence of his or her custodial parent(s). Licensee understands and agrees (i) that it is responsible for all actions of its participants and guests, (ii) that any person(s) in violation of the foregoing terms of use will be expected to immediately vacate the premises of Church, and (iii) that Church reserves the right to immediately terminate this Agreement and Licensee s use of the premises and facilities in the event of any violation of the foregoing terms of use without liability to Church.

5. Surrender of Premises Licensee shall surrender the premises and personal property described in paragraph one above, including all furniture and fixtures, upon termination of the license in the same condition as they were delivered upon commencement of the license, normal wear and tear expected. Licensee shall be responsible for the repair and/or replacement of any Church property/resource that is damaged or removed during the license term.

6. Indemnity Church and its officers, directors, agents, members, and employees shall be free from all liability and claims for damages by reason of any injury allegedly sustained by any person or to any property that is in any way connected to Licensee s use of the premises during the license term or any extension thereof. Licensee expressly agrees to defend, indemnify and hold harmless Church, its officers, members, agents, and employees, from and against any and all actions, suits, demands, losses claims, and liabilities arising out of any such injuries or property loss however occurring, including reasonable actual attorneys fees and all other costs of defending any claim.

7. Insurance Licensee warrants that it carries general liability, medical, and property insurance in amounts sufficient to cover the risks and exposures resulting from its use of the premises pursuant to the terms of this Agreement. Specifically, Licensee warrants that it carries general liability insurance in the amount of not less than one million dollars ($1,000,000) per occurrence, three million dollars ($3,000,000) aggregate. Licensee further agrees to have Church named as an additional insured on Licensee s insurance policies and will, prior to the license term commencement date, provide a certificate of insurance to Church naming Church as an additional insured. In addition to any other remedies that may be available, Church may terminate this Agreement and retain any deposit paid by Licensee in the event such certificates are not provided by Licensee prior to the license commencement date.

8. Unforeseen Events Church shall have no obligation to make its premises and facilities available to Licensee by reason of an act of God, inclement weather (as determined by Church), strike, illness, any act or order of public authority, or other unforeseen event beyond the control of Church. In such an event, Church shall have no liability to Licensee.

9. General Provisions A. No Warranty. Church does not warrant or represent that the premises and facilities are safe and suitable for Licensee s purposes. Licensee expressly acknowledges for itself and for all persons who will be utilizing the premises and facilities in connection with Licensee s purposes that Church is providing the premises and facilities on an “as is” basis. B. No Waiver. No waiver by either party or any breach of this Agreement shall be deemed a waiver of any preceding or succeeding breach. C. Assignment. This Agreement may not be assigned by either party. D. No Landlord-Tenant Relationship. Church and Licensee expressly agree that this Agreement shall not operate or be construed to create a LandlordTenant relationship between Church and Licensee under any circumstances. E. Entire Agreement/Amendment. This Agreement and attachment constitute the entire Agreement between Church and Licensee and there are no oral representations, warranties, and promises pertaining to this Agreement that are not contained in writing in this Agreement. This Agreement may be modified or amended only by subsequent written agreement signed by duly authorized representatives of Church and Licensee.

IN WITNESS WHEREOF, Church and Licensee have executed this Agreement as of the date first above written. CHURCH

LICENSEE

____________________________________________________ Signature of Church Representative

____________________________________________________ Signature

____________________________________________________ Printed Name of Church Representative

____________________________________________________ Printed Name

____________________________________________________ Title

____________________________________________________ Title


VENDOR AGREEMENT This Agreement is entered into this __________ day of __________, __________ by and between ____________________________________________________ Name of Church

and

____________________________________________________ Licensee

for the purpose of ____________________________________________________ . This Agreement shall be effective as of the date Type of Event

written above and shall end on the __________ day of __________, __________. In consideration of the mutual promises and conditions contained herein, Church and Licensee agree as follows:

Indemnity Church and its officers, directors, agents, members, employees and volunteers shall be free from all liability and claims for damages by reason of any injury allegedly sustained by any person or to any property that is any way connected to the Event or any extension thereof. Licensee expressly agrees to defend, indemnify and hold harmless Church, its officers, members, agents, employees and volunteers, from any against any and all actions, suits, demands, losses, claims and liabilities arising out of any such injuries or property loss however occurring, including reasonable actual attorneys fees and all other costs of defending any claim.

Insurance Licensee warrants that it carries general liability, medical, and property insurance in amounts sufficient to cover the risks and exposures resulting from its use of the Event. Specifically, Licensee warrants that it carries general liability insurance in the amount of not less than one million dollars ($1,000,000) per occurrence, one million dollars ($1,000,000) aggregate. Licensee further agrees to have Church named as an additional insured on Licensee s insurance policies and will, prior to the license term commencement date, provide a certificate of insurance to Church naming Church as an additional insured.

Assignment This Agreement may not be assigned by either party.

Entire Agreement/Amendment This Agreement and attachment constitute the entire Agreement between Church and Licensee and there are no oral representations, warranties and promises pertaining to this Agreement that are not contained in writing in this Agreement. This Agreement may be modified or amended only by subsequent written agreement signed by duly authorized representatives of Church and Licensee.

Governing Law This Agreement shall be governed, construed and interpreted by, through and under the Laws of the State of _____________ (enter resident state).

IN WITNESS WHEREOF, Church and Licensee have executed this Agreement as of the date first above written. CHURCH

LICENSEE

____________________________________________________ Signature of Church Representative

____________________________________________________ Signature

____________________________________________________ Printed Name of Church Representative

____________________________________________________ Printed Name

____________________________________________________ Title

____________________________________________________ Title


USE OF PREMISES INFORMATION As a part of their call to reach out to local communities, many churches allow their facilities to be used by local groups, individuals, businesses and organizations. While this is a good and noble approach, sometimes the issues and exposure such activities bring to the local church can negatively impact the ability for the church to minister in the future. For example, if a group uses your facility and leaves the doors unlocked and you are robbed, this can negatively impact ministry. Further, should someone be injured while participating in an activity of an outside group, and the group does not have insurance, your organization may be held liable. If a for-profit business regularly uses your facility and charges for its services or products, you could jeopardize your own non-profit status. Take the steps necessary to protect yourself and your ministry. Without preplanning and safeguards in place, the results could be disastrous. By answering the following questions and making sure all groups that use your facility sign the attached “Facility Usage Form,” you can decrease the likelihood of experiencing an incident that has long-term, negative consequences.

Use of Premises Form Item Do outside groups use your facilities?

Yes

No

_______________________________________________________________________________________________________________________________________ Comments Are all outside groups required to complete a “Facility of Premises” form?

Yes

No

_______________________________________________________________________________________________________________________________________ Comments Is there a method to ensure up-to-date contact names and numbers?

Yes

No

_______________________________________________________________________________________________________________________________________ Comments Is there adequate means to open and secure the facility after use?

Yes

No

_______________________________________________________________________________________________________________________________________ Comments Are outside groups required to provide a “Certificate of Insurance” naming your organization as additional insured?

Yes

No

_______________________________________________________________________________________________________________________________________ Comments Do you regularly check with your insurance agent to see if particular activities might impact your policy (e.g., karate lessons, day cares, scout troops, exercise classes, etc)? Yes No _______________________________________________________________________________________________________________________________________ Comments Does your church have a policy as to what type of organizations may or may not use your facility?

Yes

No

_______________________________________________________________________________________________________________________________________ Comments

If you answered “no” to any of the above questions, you should bring the leadership together to discuss those particular items and take corrective actions before allowing groups to use your facility. Every church should seek to reach out to organizations and individuals in their community. And by planning ahead and getting the proper paperwork in order, you can do so with a clear conscience and good will.


CHURCH USAGE UPDATED CONTACT AND USAGE DESCRIPTION INFORMATION To help us maintain a list of those organizations who use our facility and their purpose of use, please complete the following form and return to the church office. ____________________________________________________ Name of Organization

____________________________________________________ E-mail Address

Has any aspect of your organization or purpose for use changed within the last year? If yes, please give a brief description:

Yes

No

_________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________

Has any of your leadership changed in the past year (or is it due to change)? Yes No If yes, please indicate the current leadership/contact information we need to make contact with your organization:

First Contact ____________________________________________________ Name

____________________________________________________ Title

____________________________________________________ Phone Number

____________________________________________________ E-mail Address

Second Contact ____________________________________________________ Name

____________________________________________________ Title

____________________________________________________ Phone Number

____________________________________________________ E-mail Address

Third Contact ____________________________________________________ Name

____________________________________________________ Title

____________________________________________________ Phone Number

____________________________________________________ E-mail Address

Should any of the purposes of use (addition of programs, hours or days of use) or leadership change in the coming year, I agree to contact the church office to update the above information. ____________________________________________________ Name of Organization Representative

____________________________________________________ Signature of Organization Representative Date


CHURCH INTERIOR SELF-INSPECTION CHECKLIST The following general areas of concern should be assessed on a regular basis (quarterly or more often). If the answer to a question is “no,” comments and corrective action should be taken.

Item General Is there adequate lighting in the stairwells and halls?

Yes

No

_________________________________________________________________________________________________________________________ Comments Are public areas, stairways, and hallways free from any slip, trip or fall hazards?

Yes

No

_________________________________________________________________________________________________________________________ Comments Is the facility free from any signs of water leakage, damage, or mold?

Yes

No

_________________________________________________________________________________________________________________________ Comments Are hallways, stairways, and exits unobstructed?

Yes

No

_________________________________________________________________________________________________________________________ Comments Are nursery and children s areas inspected weekly prior to use for hazards?

Yes

No

_________________________________________________________________________________________________________________________ Comments Are restricted areas kept locked?

Yes

No

_________________________________________________________________________________________________________________________ Comments Are IT/computer systems backed up and are passwords utilized?

Yes

No

_________________________________________________________________________________________________________________________ Comments Is there a current contents evaluation list (off-site)?

Yes

No

_________________________________________________________________________________________________________________________ Comments Are there procedures in place for updating the contents list?

Yes

No

_________________________________________________________________________________________________________________________ Comments Are elevators regularly inspected?

Yes

No

_________________________________________________________________________________________________________________________ Comments Is elevator inspection documentation on file or posted?

Yes

No

_________________________________________________________________________________________________________________________ Comments

Mechanical and Electrical Are boilers, machinery, and other equipment inspected and documented regularly?

Yes

No

_________________________________________________________________________________________________________________________ Comments Is heating and air-conditioning equipment inspected and documented regularly?

Yes

No

_________________________________________________________________________________________________________________________ Comments A resource of AG Financial Insurance Solutions.

Is the electrical system inspected annually by a certified electrical engineer?

Yes

No

_________________________________________________________________________________________________________________________ Comments Are electrical panels/fuse/breaker boxes clean and in proper working order?

Yes

No

_________________________________________________________________________________________________________________________ Comments Are plug covers used where children congregate?

Yes

No

_________________________________________________________________________________________________________________________ Comments Are cabinet doors kept locked?

Yes

No

_________________________________________________________________________________________________________________________ Comments Are electrical rooms/areas kept clean and free from combustibles?

Yes

No

_________________________________________________________________________________________________________________________ Comments

Maintenance and Storage Are ladders approved and in working order?

Yes

No

_________________________________________________________________________________________________________________________ Comments Are cleaning chemicals marked, sealed, and locked up?

Yes

No

_________________________________________________________________________________________________________________________ Comments Are tools in clean, working order?

Yes

No

_________________________________________________________________________________________________________________________ Comments Is eye protection used when working with chemicals or on jobs with the possibility of eye injury?

Yes

No

_________________________________________________________________________________________________________________________ Comments Have maintenance and custodial workers been examined and approved by a doctor to perform their specific duties?

Yes

No

_________________________________________________________________________________________________________________________ Comments Are maintenance/repair persons properly qualified to do the specific jobs (e.g. electrical, heating, climbing, etc.)?

Yes

No

_________________________________________________________________________________________________________________________ Comments Is there sufficient warning cones/signs readily available to indicate hazards?

Yes

No

_________________________________________________________________________________________________________________________ Comments Is there a system in place for others to report hazards?

Yes

No

_________________________________________________________________________________________________________________________ Comments Are hazardous materials marked and secured?

Yes

No

_________________________________________________________________________________________________________________________ Comments


Are storage areas free from clutter?

Yes

No

_________________________________________________________________________________________________________________________ Comments Are fire doors in place and kept closed?

Yes

No

_________________________________________________________________________________________________________________________ Comments

Fire and Lighting Protection and Prevention Are hallways lighted and clear?

Yes

No

_________________________________________________________________________________________________________________________ Comments Are exit signs working?

Yes

No

_________________________________________________________________________________________________________________________ Comments Are there monitored fire, smoke, water, burglary systems?

Yes

No

_________________________________________________________________________________________________________________________ Comments Are there working, inspected fire extinguishers?

Yes

No

_________________________________________________________________________________________________________________________ Comments Are there ABC extinguishers throughout the building?

Yes

No

_________________________________________________________________________________________________________________________ Comments Is there a BC extinguisher in kitchen areas?

Yes

No

_________________________________________________________________________________________________________________________ Comments Is there a sprinkler system in place?

Yes

No

_________________________________________________________________________________________________________________________ Comments Is there adequate trash collection and disposal?

Yes

No

_________________________________________________________________________________________________________________________ Comments Is there lightning surge-suppression equipment in place?

Yes

No

_________________________________________________________________________________________________________________________ Comments

Crime and Safety Do all doors and windows have appropriate locks?

Yes

No

_________________________________________________________________________________________________________________________ Comments Is there a procedure for checking the facility before leaving each day?

Yes

No

_________________________________________________________________________________________________________________________ Comments Are staff members sufficiently protected from the general public?

Yes

No

_________________________________________________________________________________________________________________________ Comments


Are there appropriate emergency notification devices and procedures in place?

Yes

No

_________________________________________________________________________________________________________________________ Comments Are there guidelines pertaining to working after-hours or in the evening alone?

Yes

No

_________________________________________________________________________________________________________________________ Comments

Nursery Area Are all electrical outlets equipped with covers?

Yes

No

_________________________________________________________________________________________________________________________ Comments Are all doors equipped with a locking mechanism?

Yes

No

_________________________________________________________________________________________________________________________ Comments Are blind/drapery cords out of reach of children and cribs?

Yes

No

_________________________________________________________________________________________________________________________ Comments Is there a gate or door into the restroom area to prevent children from accidentally entering?

Yes

No

_________________________________________________________________________________________________________________________ Comments Are all toys clean and in good repair and unable to be swallowed?

Yes

No

_________________________________________________________________________________________________________________________ Comments Do all changing tables and high chairs have safety straps?

Yes

No

_________________________________________________________________________________________________________________________ Comments Are only modern/approved safety gates and playpens used?

Yes

No

_________________________________________________________________________________________________________________________ Comments Are cribs free from protrusions?

Yes

No

_________________________________________________________________________________________________________________________ Comments Is the crib rail at least 26 inches above the top of the mattress support?

Yes

No

_________________________________________________________________________________________________________________________ Comments Are bumper pads used in cribs where children cannot stand?

Yes

No

_________________________________________________________________________________________________________________________ Comments Are crib mattresses less than two finger widths from the side of the crib frame?

Yes

No

_________________________________________________________________________________________________________________________ Comments


____________________________________________________ Signature Date


CHURCH EXTERIOR SELF-INSPECTION CHECKLIST The following general areas of concern should be assessed on a regular basis (quarterly or more often). If the answer to a question is “no,” comments and corrective action should be taken.

Item General Are sidewalks and stairs free from cracks, chips, slip, and trip hazards?

Yes

No

_________________________________________________________________________________________________________________________ Comments Are stairs and railings in good condition?

Yes

No

_________________________________________________________________________________________________________________________ Comments Is lighting adequate around property, including entrances?

Yes

No

_________________________________________________________________________________________________________________________ Comments Are bushes trimmed around doors and windows?

Yes

No

_________________________________________________________________________________________________________________________ Comments Does lighting come on automatically?

Yes

No

_________________________________________________________________________________________________________________________ Comments Are parking lots well maintained?

Yes

No

_________________________________________________________________________________________________________________________ Comments Is tuck-pointing inspected regularly?

Yes

No

_________________________________________________________________________________________________________________________ Comments Are all structures free from hazards (loose wood, bricks, etc.)?

Yes

No

_________________________________________________________________________________________________________________________ Comments Is the roof regularly inspected and in good condition?

Yes

No

_________________________________________________________________________________________________________________________ Comments Are both exterior electrical wiring and outlets in good condition?

Yes

No

_________________________________________________________________________________________________________________________ Comments Are trees trimmed away from wires and buildings and all dead trees removed?

Yes

No

_________________________________________________________________________________________________________________________ Comments Is the property free from signs of water flow concerns or water damage?

Yes

No

_________________________________________________________________________________________________________________________ Comments Is the property free from unauthorized use by children/youth during off-hours?

Yes

No

_________________________________________________________________________________________________________________________ Comments


Is the signage adequate and properly secured?

Yes

No

_________________________________________________________________________________________________________________________ Comments

Playgrounds Is there a regular, documented inspection of the playground?

Yes

No

_________________________________________________________________________________________________________________________ Comments Is the playground surface made of acceptable material?

Yes

No

_________________________________________________________________________________________________________________________ Comments Is playground equipment safe and in good repair?

Yes

No

_________________________________________________________________________________________________________________________ Comments Is after-hours accessibility prevented?

Yes

No

_________________________________________________________________________________________________________________________ Comments


____________________________________________________ Signature Date


Section VI Financial protection

FINANCIAL SAFEGUARD QUESTIONNAIRE The following general areas of concern should be assessed on a regular basis (quarterly or more often). If the answer to a question is “no,” comments and corrective action should be taken.

Item Are members reminded to secure their valuables while attending church functions?

Yes

No

_________________________________________________________________________________________________________________________ Comments/Actions Do at least two ushers secure the offering in an inaccessible area behind at least two locks immediately after receiving the offering?

Yes

No

_________________________________________________________________________________________________________________________ Comments/Actions Are there always two adults with the funds from collection to deposit (not including when funds are locked up)?

Yes

No

_________________________________________________________________________________________________________________________ Comments/Actions Are collections always kept at the church prior to deposit?

Yes

No

_________________________________________________________________________________________________________________________ Comments/Actions Are at least two unrelated adults responsible for counting the collection?

Yes

No

_________________________________________________________________________________________________________________________ Comments/Actions Are counters required to sign a form verifying the count?

Yes

No

_________________________________________________________________________________________________________________________ Comments/Actions Are those counting money alternated (at least monthly)?

Yes

No

_________________________________________________________________________________________________________________________ Comments/Actions Do at least two people make the deposit, using alternate routes, and keeping the bank deposit bag out of view?

Yes

No

_________________________________________________________________________________________________________________________ Comments/Actions Is there adequate separation between counters, treasurer, and financial secretary (different people in each role)?

Yes

No

_________________________________________________________________________________________________________________________ Comments/Actions Are two signatures required for larger checks written out of the church account?

Yes

No

_________________________________________________________________________________________________________________________ Comments/Actions Are groups who take collections within the church required to use the same safe practices and procedures as used or practiced for the regular collection?

Yes

No

_________________________________________________________________________________________________________________________ Comments/Actions Are those regularly working with finances bonded and screened?

Yes

No

_________________________________________________________________________________________________________________________ Comments/Actions Is there an independent audit of our books conducted at least every two or three years?

Yes

No

_________________________________________________________________________________________________________________________ Comments/Actions A resource of AG Financial Insurance Solutions.

Are staff members and volunteers required to use a voucher and/or receipt system at all times for purchases made?

Yes

No

_________________________________________________________________________________________________________________________ Comments/Actions Is the petty cash secured at all times and balanced regularly?

Yes

No

_________________________________________________________________________________________________________________________ Comments/Actions Are there procedures in place for responding to an allegation of theft?

Yes

No

_________________________________________________________________________________________________________________________ Comments/Actions Has the church checked with their insurance carrier to confirm adequate coverage for loss of funds?

Yes

No

_________________________________________________________________________________________________________________________ Comments/Actions Are all credit card accounts and purchases reconciled monthly?

Yes

No



____________________________________________________ Signature Date


OFFERING/COUNTER S SHEET Date: __________________

Checks Batch/Amount

Batch/Amount

Batch/Amount

Batch/Amount

1

$___________________

13

$___________________

25

$___________________

37

$___________________

2

$___________________

14

$___________________

26

$___________________

38

$___________________

3

$___________________

15

$___________________

27

$___________________

39

$___________________

4

$___________________

16

$___________________

28

$___________________

40

$___________________

5

$___________________

17

$___________________

29

$___________________

41

$___________________

6

$___________________

18

$___________________

30

$___________________

42

$___________________

7

$___________________

19

$___________________

31

$___________________

43

$___________________

8

$___________________

20

$___________________

32

$___________________

44

$___________________

9

$___________________

21

$___________________

33

$___________________

45

$___________________

10

$___________________

22

$___________________

34

$___________________

46

$___________________

11

$___________________

23

$___________________

35

$___________________

47

$___________________

12

$___________________

24

$___________________

36

$___________________

48

$___________________

CHECK TOTAL:

$__________________

Cash Number

Currency

Total

___________________

x $100

$___________________

___________________

x $50

$___________________

___________________

x $20

$___________________

___________________

x $10

$___________________

___________________

x $5

$___________________

___________________

x $1

$___________________

___________________

Change

$___________________

CASH TOTAL:

$__________________

TOTAL OFFERING:

$__________________

____________________________________________________ Counter One Printed Name

____________________________________________________ Counter One Signature Date

____________________________________________________ Counter Two Printed Name

____________________________________________________ Counter Two Signature Date

____________________________________________________ Counter Three Printed Name

____________________________________________________ Counter Three Signature Date


Section VII Emergency preparation

DISASTER/EMERGENCY PREPAREDNESS KIT You never know when you might need to respond to an emergency. While the willingness to help is crucial, not possessing the proper tools makes any response less than effective. If an incident were to happen, such as a storm, a chemical spill, or other emergency that made it impossible to leave the church, could you sustain your staff or other members present for a short period of time? The following is a list of items that will help you be prepared. These supplies should be able to last a minimum of 72 hours. These are some of the items your staff or other members should consider. • • • • • • • • • • • • • • • • • • • • • •

Food (non-perishable) Water (36 oz. to one gallon per person per day). Weather radio (solar-powered or extra batteries) Can opener (non-electric) First-aid kit Paper cups, plates, utensils, napkins/paper towels Moist towelettes Plastic bucket with tight lid Toilet paper Plastic bags with ties Communication devices (two-way radios, cell phones) Emergency contact numbers including media and power companies Candles and lighter or matches Blankets (space blankets if possible) Plastic sheeting and duct tape Basic tool kit Whistle Army knife Work gloves Safety goggles Dust masks Bible

Should there be a need to close down and secure the building, these items should be sufficient to sustain a staff or small group for a period of several days until additional help arrives. A more complete list of supplies would be necessary if you were setting up a shelter (see other parts of this section for resources). Besides having the requisite supplies available, you should also have a response plan should something happen. Members will be looking to church leaders to help guide them during perilous circumstances. It is important that all equipment that may be considered necessary in an emergency be in its designated place and in good working order. Without emergency provisions in place, any response will be less than adequate.


EMERGENCY CONTACTS This should be distributed to all department heads and everyone on the list and should be updated at least twice a year. Display in prominent areas and near phones and computers.

Agency Phone Numbers ____________________________________________________ Police Department

____________________________________________________ County Sheriff

____________________________________________________ State Police

____________________________________________________ Fire Department

____________________________________________________ Ambulance

____________________________________________________ City Police

____________________________________________________ Hospital One

____________________________________________________ Hospital Two

____________________________________________________ Child Protective Services

____________________________________________________ Poison Control Center

____________________________________________________ Emergency Services

____________________________________________________ Mental Healthcare

____________________________________________________ Insurance Company (and Agent Name)

____________________________________________________ Attorney

Radio and Television (for Closings) _________________________________________________________________________________________________________________________ Name Phone Number E-mail Web Address _________________________________________________________________________________________________________________________ Name Phone Number E-mail Web Address _________________________________________________________________________________________________________________________ Name Phone Number E-mail Web Address _________________________________________________________________________________________________________________________ Name Phone Number E-mail Web Address _________________________________________________________________________________________________________________________ Name Phone Number E-mail Web Address _________________________________________________________________________________________________________________________ Name Phone Number E-mail Web Address _________________________________________________________________________________________________________________________ Name Phone Number E-mail Web Address _________________________________________________________________________________________________________________________ Name Phone Number E-mail Web Address _________________________________________________________________________________________________________________________ Name Phone Number E-mail Web Address _________________________________________________________________________________________________________________________ Name Phone Number E-mail Web Address _________________________________________________________________________________________________________________________ Name Phone Number E-mail Web Address _________________________________________________________________________________________________________________________ Name Phone Number E-mail Web Address _________________________________________________________________________________________________________________________ Name Phone Number E-mail Web Address


Church Contacts Pastors _________________________________________________________________________________________________________________________ Name Phone Number E-mail _________________________________________________________________________________________________________________________ Name Phone Number E-mail _________________________________________________________________________________________________________________________ Name Phone Number E-mail _________________________________________________________________________________________________________________________ Name Phone Number E-mail _________________________________________________________________________________________________________________________ Name Phone Number E-mail _________________________________________________________________________________________________________________________ Name Phone Number E-mail

Office Staff _________________________________________________________________________________________________________________________ Name Phone Number E-mail _________________________________________________________________________________________________________________________ Name Phone Number E-mail _________________________________________________________________________________________________________________________ Name Phone Number E-mail

Board Chair _________________________________________________________________________________________________________________________ Name Phone Number E-mail

Custodian _________________________________________________________________________________________________________________________ Name Phone Number E-mail

Denominational Contacts _________________________________________________________________________________________________________________________ Name Phone Number E-mail _________________________________________________________________________________________________________________________ Name Phone Number E-mail _________________________________________________________________________________________________________________________ Name Phone Number E-mail

Other Important Contacts _________________________________________________________________________________________________________________________ Name Phone Number E-mail _________________________________________________________________________________________________________________________ Name Phone Number E-mail _________________________________________________________________________________________________________________________ Name Phone Number E-mail _________________________________________________________________________________________________________________________ Name Phone Number E-mail


EMERGENCY PREPARATION CHECKLIST It is important to know practices and procedures are in place to respond to an emergency. If the answer to a question is “no,” comments and corrective action should be taken.

Item Is there a written plan that addresses how to respond to an emergency?

Yes

No

_________________________________________________________________________________________________________________________ Comments Does each staff member, usher, and leader know their role during an emergency?

Yes

No

_________________________________________________________________________________________________________________________ Comments Does each staff member, usher, and leader know when and how to evacuate or seek shelter?

Yes

No

_________________________________________________________________________________________________________________________ Comments Are facilities inspections conducted and documented regularly?

Yes

No

_________________________________________________________________________________________________________________________ Comments Is there a quickly accessible call list for staff, members, and emergency personnel?

Yes

No

_________________________________________________________________________________________________________________________ Comments Are the supply kits and equipment needed for various emergencies adequate and available?

Yes

No

_________________________________________________________________________________________________________________________ Comments Is there a plan in place to assist in response and recovery should a community disaster or emergency occur?

Yes

No

_________________________________________________________________________________________________________________________ Comments Is there a designated emergency response/medical team?

Yes

No

_________________________________________________________________________________________________________________________ Comments Do all of the designated people know how to turn off the utilities?

Yes

No

_________________________________________________________________________________________________________________________ Comments Has an emergency evacuation drill been practiced during worship?

Yes

No

_________________________________________________________________________________________________________________________ Comments Do all staff and volunteer child-care providers know how children and infants are to be evacuated and how to account for each of them?

Yes

No

_________________________________________________________________________________________________________________________ Comments If the facility burnt down or was not able to be used, is there a designated meeting place?

Yes

No

_________________________________________________________________________________________________________________________ Comments Are important records backed up with both hard copies and computer files?

Yes

No

_________________________________________________________________________________________________________________________ Comments


Is there a “safe” copy of the entire inventory located off site?

Yes

No

_________________________________________________________________________________________________________________________ Comments Does each staff member, usher, and leader know who the insurance agent is and is his/her number readily available?

Yes

No

_________________________________________________________________________________________________________________________ Comments


____________________________________________________ Signature Date


Section VIII Personal safety and security

PERSONAL SAFETY AND SECURITY CHECKLIST The following checklist is to determine how safe and secure the people in your organization are. For those answered with a “no”, action should be taken.

Item Are the children s areas and outside play areas regularly inspected?

Yes

No

_________________________________________________________________________________________________________________________ Comments Is there always a proper ration when children and youth are involved in activities?

Yes

No

_________________________________________________________________________________________________________________________ Comments Is equipment always checked before any extreme activities?

Yes

No

_________________________________________________________________________________________________________________________ Comments Are adult s leaders and youth always trained before supervising an extreme activity?

Yes

No

_________________________________________________________________________________________________________________________ Comments Is there regularly scheduled training for staff and volunteers?

Yes

No

_________________________________________________________________________________________________________________________ Comments Are children released only to their parents?

Yes

No

_________________________________________________________________________________________________________________________ Comments Are children being supervised after they are released to their parents?

Yes

No

_________________________________________________________________________________________________________________________ Comments Are members cautioned to keep their cars locked and valuables with them or secured?

Yes

No

_________________________________________________________________________________________________________________________ Comments Is all volunteer work required to be done with at least two people?

Yes

No

_________________________________________________________________________________________________________________________ Comments Are all kitchen usage rules posted?

Yes

No

_________________________________________________________________________________________________________________________ Comments Do members know how best to notify leadership of hazards?

Yes

No

_________________________________________________________________________________________________________________________ Comments Are ushers trained to respond to emergencies and patrol the halls?

Yes

No

_________________________________________________________________________________________________________________________ Comments Is there a plan in place to assist the elderly and disabled?

Yes

No

_________________________________________________________________________________________________________________________ Comments


Are there written policies for staff working in the church alone?

Yes

No

_________________________________________________________________________________________________________________________ Comments Are there sufficient soft and hard barriers in place to protect office staff and other staff members?

Yes

No

_________________________________________________________________________________________________________________________ Comments Are all required state and federal worker guidelines followed?

Yes

No

_________________________________________________________________________________________________________________________ Comments Is there an injury and illness prevention program in place?

Yes

No

_________________________________________________________________________________________________________________________ Comments Are all work areas regularly inspected?

Yes

No

_________________________________________________________________________________________________________________________ Comments Are workers provided safety equipment and given instructions on its usage?

Yes

No

_________________________________________________________________________________________________________________________ Comments Are workers properly supervised?

Yes

No

_________________________________________________________________________________________________________________________ Comments Do all positions have written job descriptions?

Yes

No

_________________________________________________________________________________________________________________________ Comments Is there a clear method for workers to communicate work concerns?

Yes

No

_________________________________________________________________________________________________________________________ Comments Are worker concerns addressed in a prompt, effective manner?

Yes

No

_________________________________________________________________________________________________________________________ Comments Have ergonomics evaluations been conducted on all workstations?

Yes

No

_________________________________________________________________________________________________________________________ Comments Are workers evaluated to ensure they are fit for duty in relation to their job description?

Yes

No

_________________________________________________________________________________________________________________________ Comments


____________________________________________________ Signature Date


ACTIVITY PARTICIPATION AGREEMENT Activity Information ____________________________________________________ Sponsor/Church Name

____________________________________________________ Location Date

_________________________________________________________________________________________________________________________ Description

Participant Information To be completed by a parent or an authorized guardian if participant is a minor. ____________________________________________________ Name

____________________________________________________ E-mail

____________________________________________________ Phone Number _________________________________________________________________________________________________________________________ Address City State Zip

Emergency Contact Information ____________________________________________________ Name

____________________________________________________ E-mail

____________________________________________________ Daytime Phone Number

____________________________________________________ Evening Phone Number

Is sponsor authorized to approve medical treatment?

Yes

Is participant covered by personal/family medical insurance? If yes, please provide:

No Yes

____________________________________________________ Insurance Provider

No ____________________________________________________ Policy or Group Number

Participant Agreement

By signing below, the participant (or parent/guardian if participant is a minor) acknowledges and accepts the risks of physical injury associated with participation in the activity described above. Except for gross negligence on the part of the sponsor and/or its representatives, including employees, and/or its volunteers, the participant (or parent/guardian) accepts personal financial responsibility for any bodily or personal injury sustained during the activity. Further, the participant (or parent/guardian) promises to hold harmless the sponsor listed above and its representatives, including employees, and its volunteers, for any injury related to the activity. If a dispute over this agreement or any claim for damages arises, the participant (or parent/guardian) agrees to resolve the matter through a mutually acceptable arbitration process.

____________________________________________________ Printed Name (Participant or parent/guardian if minor)

Is the participant on any medication or allergic to anything? If yes, please list:

____________________________________________________ Signature (Participant or parent/guardian if minor) Date

Yes

No

_________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________


PARENTAL PERMISSION AND MEDICAL CONSENT Child Information ____________________________________________________ Name

____________________________________________________ Name of Parent(s) or Guardian(s)

____________________________________________________ Date of Birth

____________________________________________________ Social Security Number

_________________________________________________________________________________________________________________________ Address

Activity Information ____________________________________________________ Name

____________________________________________________ Organizer

_________________________________________________________________________________________________________________________ Description ____________________________________________________ Start Date

____________________________________________________ End Date

_________________________________________________________________________________________________________________________ Restricted Activities The undersigned being the lawful parent(s) and/or guardian(s) of the above child (the child) hereby consent to the participation by the child in the activity listed above conducted by the Organizer listed above and to the participation of child in all the events relating to the activity on the dates listed above. The undersigned hereby certifies that the child is able to participate in the above described activity without limitation, except the Restricted Activities listed above. The undersigned hereby further authorizes any of the employees, agents and/or representatives of the Organizer to (i) provide for, approve and authorize any health care at any hospital, emergency room, doctor s office or other institution; (ii) employ any physicians, dentists, nurses or other person whose services may be needed for such health care; (iii) review and, if necessary, disclose the contents of any confidential medical records; and, (iv) execute consent forms required by medical, dental or other health authorities incident to the provision of medical, surgical or dental care to the child. The undersigned acknowledges completion of a health history form which is attached hereto. (Please list any updates here that are to be noted since completion of the most recent form): If there is no medical emergency the Organizer will first use reasonable efforts to contact the parent and/or guardian before agreeing to authorize any treatment. Notwithstanding any of the provisions of this consent form, Organizer shall not have the authority to withhold or withdraw lifesaving procedures for the child.

Parent/Guardian Agreement ____________________________________________________ Printed Name of Parent or Guardian Individually and on behalf of the Child

____________________________________________________ Signature of Parent or Guardian

____________________________________________________ Printed Name of Parent or Guardian Individually and on behalf of the Child

____________________________________________________ Signature of Parent or Guardian

Subscribed to and sworn to before me NOTARY PUBLIC

____________________________________________________ Notary Public A resource of AG Financial Insurance Solutions.

Section IX Property protection

CHURCH INVENTORY LIST Copy a sheet for each room/area in the church; use more than one sheet if needed. ____________________________________________________ Room Number, Name or Area

____________________________________________________ Use of Room/Area

General contents of room/area: _________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________

Specific equipment/property to be noted:

Item(s) Name

Brief Description

Model/ Serial Number

Approximate Age

Estimated Value

Inventory completed by: _________________________________________________________________________________________________________________________ Printed Name Signature Title Date


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