This form needs to be filled out by both the student and a parent or legal guardian!

Full Name *
First Name
Last Name
Date of Birth (mm/dd/yyyy)*
Address *
Address Line 1
Address Line 2
Postal Code
Phone (xxx-xxx-xxxx)
Do you regularly attend (check box): *
Are you a Christian? If yes, how do you know? *
What are some things you do to keep your relationship with Christ growing? *
Tell us about hobbies or talents you have. What are you good at doing? *
Do you have experience with volunteering? If so, please explain.
Where do you want to volunteer at CTR and why?*
If you want to volunteer with kids tell us your experience (like babysitting). *
LIFE STUFF: When we serve, we represent Jesus and our church. We have to make sure that the way we live our life matches what the Bible teaches. We have to be careful that we don't say one thing, but do another. So, do you promise to:
NOT use alcohol*
NOT smoke cigarettes*
NOT view pornography*
NOT use illegal drugs*
Not be sexually active?*
Not worship or follow something or someone other than God (e.g., séances, palm reading, tarot cards, etc.)?*
Use this space to tell us more about anything listed above or to write out any questions you may have about anything
Full Name of Reference 1*
Phone Number of Reference 1 (xxx-xxx-xxxx)
How long have you know Reference 1?*
How do you know Reference 1?*
Email of Reference 1
Full Name of Reference 2*
Phone Number of Reference 2 (xxx-xxx-xxxx)
How long have you known Reference 2?*
How do you know Reference 2?*
Email of Reference 2
Will you commit to the following policies? If you agree, initial below each statement, and type your name and today's date below stating that you have filled out this form. Thank you!
Be on time for committed timeframe
Find a sub if unable to volunteer due to a prior commitment or emergency
Notify ministry leaders/staff if unable to find a sub
Come prepared by reviewing prep materials, if applicable (i.e., class curriculum)
Not use cell phones during committed timeframe
Not use volunteer time to socialize with friends
Please type your name below and put the date that you filled out this form. Thanks!*
Today's Date (mm/dd/yyyy)*
PARENT'S STUFF: Christ The Rock considers it a privilege to work with our student volunteers. We see this as an opportunity to help your child/youth discover their passions and talents as they give of their time to serve. Please help us get to know them better.
Describe your child's relationship with God *
Does your child have any physical conditions that would prevent them from doing any activities? Please list *
Do you support your child serving at Christ The Rock?*
Will you be able to provide transportation and other assistance so that they may serve as scheduled?*
Will you help your child adhere to the guidelines established by the ministry?*
Will you support your child/youth by helping them commit to the following ministry policies? (If you agree, initial below each statement)
Be on time for committed timeframe
Find a sub if unable to volunteer due to a prior commitment or emergency
Notify ministry leaders/staff if unable to find a sub
Come prepared by reviewing prep materials, if applicable (i.e., class curriculum)
Not use cell phones during committed timeframe
Not use volunteer time to socialize with friends
How does your child/youth respond to authority?
How does our child/youth handle responsibility?
Do you have any concerns about your child’s/youth’s ability to communication with adult team members and parents?
Is there anything else that you would like us to know regarding your child serving at CTR? *
I give permission for my son/daughter to serve at Christ The Rock Community Church, and for the church’s designated representatives to call the references listed to inquire about my child.*
Date (mm/dd/yyyy)*
Parents phone number (xxx-xxx-xxxx)
Parents Email


This form must be read and signed by anyone who will be volunteering directly with minors. Note that some points may not pertain to specific volunteer roles.

Who should read this policy?

  • All approved leaders and volunteers working directly with children/youth at Christ The Rock (CTR)

Why is there a policy?

  • To prevent abuse from happening to children/youth while involved with CTR staff/programs
  • To help protect staff and volunteers from being falsely accused of child abuse

What are the expectations?

  • That these policies and guidelines will be read and followed by everyone involved with children/youth

Where does this policy apply?

  • At all activities sponsored by Christ The Rock on or off campus

What is the policy?

Adequate Supervision

  • Two non-related, approved leaders/volunteers are to be present at all times during activities that involve children/youth.
  • No one-on-one contact. Keep conversations/activity within full view of the group and other leaders/volunteers. This prevents isolation of a leader with a child/youth.
  • Punishing children/youth by hitting or yelling is not permitted.
  • Youth volunteers only discipline children with adult guidance.

Respect Privacy

  • Dress appropriately/modestly to ensure your personal privacy.
  • Touching a child/youth should be limited to placing a hand on the individual’s shoulders, hands, arms, head or upper back.
  • Touching must be non-demanding. This means that hugs and kisses should not be asked for by a leader/volunteer and they should not be forced upon a child/youth.
  • No use of digital devices in places where privacy is expected, i.e. bathrooms, changing rooms, etc.
  • Bathroom Policy when serving with children:

Only trained leaders/volunteers may change diapers and must stay in full view of the classroom.

Children in the 2 year old through K/1 rooms must use the bathrooms in the room. If half doors, leaders/volunteers may go into the bathroom with the child and assist them as needed. If no half door, leaders/volunteers stay outside and wait.

2nd-3rd graders must have a leader/volunteer walk them to the bathroom and stay outside and wait.

4th-5th graders may go to the bathroom on their own.

Responsible to Remind and Report

  • If you see a violation of the policies and guidelines that seems innocent, immediately take the leader/volunteer aside and remind them that the conduct is not appropriate. Refer to this policy as needed.
  • If a child tells you that they are being abused (physically, sexually, emotionally), tell them that for their protection you need to report the abuse to a pastor so they can get help. Do not agree to keep it a secret. Speak to the team leader, ministry leader, or a pastor immediately and do not discuss the situation with others.
  • If you are suspicious that abusive behavior may be happening, immediately bring the situation to the attention of the team leader, ministry leader, or a pastor. Do not discuss the situation with others.

Please sign your name below if you have read and agree with Christ The Rock's Child/Youth Protection Policy.

VOLUNTEER and PARENT: If you will be serving in Children or Student Ministries, please type your names and date below stating that you have read and are in agreement with the above policy.
Date I/we reviewed and agreed to policy (mm/dd/yyyy):