Verification of No Church Programs for Minors

Required use for District Affiliated Churches with no church programs for minors.
Name of Church *
City & State *
Check all the statements below that apply: *

We do not offer supervised activities for children. We do not offer supervised activities for youth. We do not offer supervised Sunday School. We do not offer supervised nursery. Those under the age of 18 are always supervised by their parents. We do not have supervised ministries to minors. We will not have supervised activities without notifying the District and having workers screened.
This is to confirm that the church has no children's ministries, childcare, or youth ministries. Minors are supervised by their guardians that brought them on site.
Pastor's Statement

As the Senior Pastor I confirm that our church does not have any programs or activities of any kind for minors at the present time. If we reach a place where we are ready to offer supervised activities for minors, I will contact Dr. Huddleston's office immediately.
Senior Pastor's Signature *

Clear
Senior Pastors Printed Name *
Date *

Month Day Year
Date
Should be Empty:

Verification of No Programs for Minors

Verification of No Church Programs for Minors