This form is to be completed by all those currently serving or interested in serving in the Children’s Ministry at Katy Christian Community Church (KCCC). It is being used to help KCCC provide a safe and secure environment for those minors who participate in our programs and use our facilities. All the information is held strictly confidential.  所有已經在服事或有負擔在凱地中國教會（KCCC）兒童事工服事的同工均需填寫此表格。所有資料嚴格保密。

Applicant's Release & Statement

I hereby acknowledge that the information contained in this application is correct to the best of my knowledge. I authorize any references or churches listed in this application to give you any information they may have regarding my character and fitness for ministry, and I release all such references from liability for any damage that may result from furnishing such evaluation to you. I also grant my permission for KCCC to perform a personal criminal background check for the purpose of my protection against any false allegations and for the protection of those I serve.  I consent to such an investigation with the understanding that the results will be kept in extreme confidentiality.  I further agree to adhere to the Ministry Policies and guidelines including the Minors Protection Policy as adopted by KCCC.

I have read the attached Statement of Faith of KCCC. Should my application be accepted, I affirm that I agree with the Doctrinal Statement and Policies of KCCC and I agree to refrain from unscriptural conduct in the performance of my services on behalf of this church.