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Draft Limited Access Agreement—Confidential

Paragraph Format

Introductory paragraph in cases of allegation:

A serious complaint or allegation, now under review, has been made about you to the Sexual Misconduct and Abuse Response Team. While this complaint is being investigated, in order to protect the children and youth in our programs from potential risk, and in order to protect you from further suspicion, we ask you to abide by this interim agreement. Signing this document in no way constitutes a presumption or confession of guilt. This is a routine safety precaution, activated without prejudice toward particular individuals or circumstances. This document will be made known only to the Minister, the Religious Educator and the members of the Response Team (or other appropriate congregational entity). It will be kept in a locked file in the office.

Introductory paragraph in cases of convicted sex offender:

The NAME OF CONGREGATION affirms the dignity and worth of all persons. We are committed to being a religious community open to those who are in need of worshipping with us, especially in times of serious personal troubles. However, based on your background, we have concerns about your contact with children and youth in our congregation. The following guidelines are designed to reduce the risk to both you and them of an incident or accusation. We welcome you to our congregation and our membership but your participation will be limited to ensure the safety of our children and youth and to assure that you will not be subject to future accusations.


Within these guidelines, the congregation welcomes your participation in adult worship services, coffee hour, committee meetings, adult education, all adult social events, and well supervised intergenerational events. You are to avoid all contact with children on congregation property or congregation-sponsored events. This includes the following:

  • Please do not talk with children.
  • Please do not volunteer or agree to lead, chaperone or participate in events for children and youth including such things as religious education classes, stories or talks for worship, youth group events, activities during intergenerational events, driving or otherwise transporting children and/or youth.
  • Please remain in the presence of an adult who knows your situation at all times when children are present.
  • If a child in the congregation approaches you, either at church or in a community place, politely and immediately excuse yourself from the situation.
  • Please avoid being in the building unsupervised when activities involving children are in session, such as nursery school or youth group.

I accept that the following people will be told of my circumstances in order for them to protect the children/young people for whom they care: INSERT NAMES AND/OR POSITIONS WITHIN THE CONGREGATION

I have reviewed this covenant and agree to abide by its provisions. I understand and agree that if I violate this agreement, I will be denied access to future church functions and church property.

I understand that this contract will be reviewed regularly every six months and will remain for an indefinite period.










Director/Minister of Religious Education:



Board Chair: