Redeemer City to City - Background Check Form

Due to the fallen nature of the world in which we live, and our responsibility to evaluate each participant to the best of our ability, we ask that all potential participants working with minors sign the following. This is needed in order to provide the maximum protection and safeguards for all involved. Anyone who has a criminal background in child sexual abuse or has admitted guilt to child sexual abuse (including crimes committed against teenagers) will not be allowed to participate in any Redeemer/City to City short-term missions’ trip involving minors, regardless of when the offense occurred. By signing this form you are stating that you do not have a criminal background in child sexual abuse or have not admitted guilt to child sexual abuse, including teenagers. We will also run a background check through an outside vendor. Please go to the next page to sign a permission form for the background check. Please return to: Redeemer Presbyterian Church/City to City 1359 Broadway, 4th Flr. New York, NY 10018 Attn.: Christina Stanton 212.808.4465 (fax)

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