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Safe Environment Application - Youth

Commitment to the Code of Conduct and Authorization for Youth Working with Younger Children

THANK YOU for your interest in volunteering at St. Elizabeth Ann Seton Catholic Church. The Diocese of Fort Wayne-South Bend requires that all volunteers working with children or teenagers on a regular basis go through a screening process to ensure the safety of the children and teenagers at our parish.

Please note that completing the application process does not guarantee that you are able to participate as a volunteer with children or teenagers at the parish. If you have any questions, please contact the parish staff member with whom you are volunteering or the parish's Safe Environment Coordinator in the parish office at 260-432-0268.

Please review the Code of Conduct  issued by the Diocese of Fort Wayne-South Bend outlined below prior to completing your application.

CODE OF CONDUCT for YOUTH WORKING WITH YOUNGER CHILDREN

The Diocese of Fort Wayne-South Bend requires completion of this form for any person under eighteen years of age who will work or volunteer with younger children. The diocese along with your parish or school thank you for your offer of service. It is a privilege to carry on the mission of Jesus Christ; one that no one should take lightly. As a minor yourself, it is important that you follow certain rules and guidelines , both for your protection and for the protection of those to whom you minister. The diocese and your parish/school take the issue of misconduct very seriously. Any instance of your misconduct will be evaluated carefully, and it is very important that you report any instances of misconduct or concern that you see to the adult in charge of your area of service.

GENERAL CONDUCT FOR YOUTH VOLUNTEERS/WORKERS

  1. Do not be alone or isolated with a younger child in your care.

  2. Do not enter locker rooms, shower rooms or dressing rooms where younger children in your care are present unless there is an emergency.

  3. Never transport a younger child in your care in a car unless the child is a family member, or you have permission from the parents. Permission should be in writing.

  4. Although children look to you as a role model and friend, you must maintain professional physical boundaries with children. Do not carry a younger child, play piggyback, or allow a child to sit on your lap. Infants and babies may be carried as necessary for their care.

  5. When on an outing or field trip with younger children, there must be two adults present always.

  6. Do not accompany a younger child in your care into a restroom unless the child must have assistance. If assistance is required, two caregivers must be present.

  7. Do not use inappropriate language or jokes when working with younger children. Avoid using sarcasm. Never make fun of a child or put down a child.

  8. Never use or have possession of illegal drugs and/or alcohol.

  9. Do not use physical force or demeaning language in disciplining younger children in your care.

  10. You have a position of responsibility within your parish/school. In this position you are a role model for younger children. Strive to always to live up to the expectations of trust that have been placed in you.

  11. If you suspect that a child is being harmed physically, emotionally, or sexually, report this to the adult in charge of your area of service immediately.

  12. Be both physically and mentally present while you are working with or supervising children. Do not use your cell phone or other electronics unless it is an emergency.

  13. Do not photograph children in your care using your cell phone. Do not allow children to use your cell phone or electronics. 

  14. Never give or accept gifts from children in your care unless approved by your supervisor.

The parish/school is grateful for the service you provide and wants to help you provide it in a manner that is safe for you and for the children you serve. Whenever you have questions or whenever you are uncertain about what is required, ask the adult supervisor with whom you work or volunteer.

 

Safe Environment Training - Youth serving minors
Effective 4/15/2018

Diocese of Fort Wayne-South Bend Safe Environment
COMMITMENT TO THE CODE OF CONDUCT AND AUTHORIZATION FOR YOUTH WORKING WITH YOUNGER CHILDREN
I promise to follow faithfully the rules and guidelines in the Diocese of Fort Wayne-South Bend Code of Conduct for Youth Working with Younger Children as a condition of my providing services to children.
I understand that any action inconsistent with the Diocese of Fort Wayne-South Bend Code of Conduct for Youth Working with Younger Children or any failure to act mandated by the Code may result in my removal from my position of working with children.
I further understand that I may, as a condition of continuing in my position, be required to participate in education and training provided by the parish, school, or diocese.
Name
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Date of Birth //
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Phone --
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Address
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By typing my name below and submitting this application, I certify that I am the person who is applying for the volunteer position on this application form.
Signature of Youth
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Date //
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Parent Information
I am the parent/legal guardian of
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I have received and support the Diocese of Fort Wayne-South Bend Code of Conduct for Youth Working with Younger Children and I have reviewed it with my son/daughter. I understand that the parish/school has a responsbility to provide a safe environment for all its young people. I understand that my son/daughter will need to receive training to qualify to perform the service that is assigned. I certify that I am not aware of any problem with or past conduct on the part of my child which indiates, to any degree, that my child may pose a risk of harm to himself/herself or to others with whom my child may interact as a volunteer for the diocese. I understand that the diocese retains the right, in its sole discretion, to determine whether my child may perform service for the diocese.
Parent Name
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By typing my name below and submitting this application, I certify that I am the parent or guardian of the child or teen who is applying for the volunteer position on this application form.
Parent Signature
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Date //
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Email
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Preferred Phone --
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Alternate Phone --
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Emergency Contact
Name
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Phone --
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Relationship
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Spam Capture
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