Chaperone Application with Background Check

Form 1: Chaperone Application

Thank you for your willingness to bless our children through your ministry as a chaperone for field trips and/or other off-site events. Every chaperone must have a signed application and a background investigation at the school's expense. This form is only valid for the current school year and must be completed annually. Please contact the main office if you have any questions about these guidelines.

Expectations

At all times while on the school grounds or at a school-sponsored event, and off campus when LCS students other than the chaperone's family member(s) are present, chaperones agree to serve as a Christian role model for our students. During these times, chaperones agree to set an example by modeling maturity in actions, attitudes, speech and dress and to refrain from the use of alcohol, illegal substances or tobacco products.

To facilitate timely communication, chaperones are asked to bring a cell phone to the event and to give the cell phone's number to the staff member in charge. If, during the event, you are unable to reach the staff member in charge, please contact the campus directly: elementary (765-644-7773) or secondary (765-644-7774).

An LCS staff member/employee will be in charge of each event, activity or field trip and will instruct the chaperone of expectations at that event.

Chaperones are responsible for the behavior of students assigned to their supervision. A chaperone must remain with the student(s) for whom the chaperone is responsible. At no time is a student to be left unsupervised. Do not allow students to engage in rowdiness, disrespect, inappropriate voices or any potentially dangerous behavior. If you are experiencing difficulties, please report the problem immediately to the supervising school employee.

Chaperones should not bring others (whether children or other guests) to or arrange for others to meet them at an event, activity or field trip, unless it has been previously announced as a family event or one to which other guests are specifically invited. It is nearly impossible for a parent of a small child to give that child proper attention and also to provide the necessary vigilance to safely supervise a group of students. During the event, activity or field trip, the first responsibility of each chaperone is to the students with whom the chaperone is working. Those students need the undivided attention of the chaperone. We are grateful that our chaperones understand the school's priorities.

Students must travel to and from off-campus school events or activities in school-sponsored vehicles. Only an administrator or the sponsoring teacher can make an exception to this. In most cases, exceptions are reserved for emergency situations or are approved prior to the event.

Chaperones should refrain from purchasing special treats for the children they are supervising unless all the children at the event or activity benefit equally.
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Form 2: BACKGROUND CHECK FOR VOLUNTEER PARTNERS

To provide for the safety of and godly examples to our students, Liberty Christian School requires all volunteers (including but not limited to classroom volunteers, field trip chaperones, volunteer drivers or volunteer coaches) to submit to a background investigation at the school’s expense before supervising or working directly with students. The Criminal Records Section of the Indiana State Police performs the criminal background check.

Our school also requires a driver’s record check for anyone offering to be a volunteer driver. Please complete the “Criminal History Affidavit” below and sign the authorization for the school to perform a criminal background check.

For those volunteering to serve as a driver, please go to the BMV website, https://secure.in.gov/BMV/mybmv/Default.aspx?ReturnUrl=%2fBMV%2fmybmv%2fMyDriver%2fDriverRecord.aspx, print a free copy of your driving record, and attach it to this affidavit. Your written application remains on file and is valid from year to year. However, the criminal history affidavit, the limited criminal history check, and (if applicable) the driver’s record review must be updated annually.

Criminal History Affidavit and Authorization to Conduct a Limited Criminal History Background Check

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Finally, I affirm (Check the applicable box)
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The information contained on this form is correct to the best of my knowledge. I agree to all terms.
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