PROTOCOLS
for the Protection of Sexual Abuse Victims  
and the Integration and Inclusion of Sexual Offenders

9.0       APPENDICES 

ADMINISTRATION PROTOCOL STEPS – SEXUAL OFFENDER

*Note: A convicted sex offender will be immediately placed on the Sex Offender Registry whether they are imprisoned or released.

ADMINISTRATION LETTERS/ FORMS →WHAT IS THE LETTER OR FORM (ABBREVIATED) →SEND OR COMPLETE

Immediate Response to Abuse

 Appendix A: Critical Response form – must be completed ASAP after an incident

To Victim of Abuse

 Appendix B: Consent letter – Adult Victim only: letter allowing (or not) sex offender to attend MVCRC - ASAP

To Alleged Sexual Offender

Appendix D: Release form/letter – Alleged sexual abuse but NO charges laid – Release Personal Information - ASAP

To a Sexual Offender  

 Appendix E: Dismissal letter – Offence committed against MVCRC child / young / vulnerable person - ASAP

Appendix F: Letter to offender – CHARGED & OUT ON BAIL , Victim does not attend MVCRC - ASAP. Attach Appx I

Appendix G: Letter to offender – PROBATION/PAROLE ORDER/SEXUAL REGISTRY. Victim does not attend MVCRC * 1st letter: on Sex Offender Registry, suspended sentence,; in prison or released. Attach Appx J

Appendix H: Letter to offender – On SEXUAL REGISTRY only (wants to attend MVCRC); ASAP. Attach Appx K

Appendix I: Release form – CHARGED and/or out on BAIL ; Include with Appx F

Appendix J: Release form – Release form on PROBATION/PAROLE ORDER/SEXUAL REGISTRY; Include with Appx G

Appendix K: Release form – On SEX OFFENDER REGISTRY; Include with Appx H

Appendix M: Offender Dismissal – Refuses to sign Covenant or in violation of Covenant terms/conditions ASAP

Appendix C: Covenant – Accountability Covenant (approved by church lawyer) ; when Rel. forms signed etc.

To Probation Officer

 Appendix N: Letter – Advising offender is dismissed/suspended from church; When dismissed

To Congregation 

Appendix L: First letter – When there are known CHARGES/ COUNTS against a member; ASAP when offences known

 *All correspondence should be sent Registered mail and a copy of the correspondence should be filed with that receipt.

APPENDIX A           
CRITICAL INCIDENT RESPONSE FORM (CIRF)      
This form must be completed as it is an official record

Date of Incident:  ___________________________      Date Reported: _________________________

Complainant’s Name: _______________________________ Telephone: _______________________

Address: ___________________________________________________________________________

A VICTIM WHO IS A CHILD/YOUNG PERSON/ VULNERABLE PERSON: (for an Adult see page 2) 

 Victim’s Name: ___________________________________________________________    Age: _____

Parent or Guardian Name(s): ___________________________________________________________

Telephone #:  ____________________________________________________

Parent or Guardian Address: ____________________________________________________________

Signature of Parent/Guardian: ___________________________________________________________

This CIRF is a record.  If the parent/guardian of the child/young person/vulnerable person DO NOT consent to sign this form, you MUST still complete this document.  Include date & time and why consent to sign this form was denied.             

VICTIM IN IMMEDIATE DANGER AND/OR A PERSON IS DISCOVERED COMMITTING A SEXUAL OFFENCE.  Personal Steps Required: Contact Police 911 and FACS Niagara 905-937-7731.  Call an ambulance if necessary and find a secure place.  Then as soon as you are able complete below “what was witnessed/disclosed”.  

VICTIM NOT IN IMMEDIATE DANGER:  Personal Steps Required: Contact Police 911 and FACS Niagara 905-937-7731.  Complete below what was "witnessed/disclosed": 

CHILD/YOUNG PERSON/VULNERABLE PERSON: WHAT WAS WITNESSED/DISCLOSED - description of

assailant/sexual offender, description of physical/emotional state of victim (word-for-word if possible): 

___________________________________________________________________________________

___________________________________________________________________________________

___________________________________________________________________________________

FURTHER ACTION NEEDED WHEN VICTIM IS A CHILD/YOUNG PERSON/VULNERABLE PERSON

I HAVE advised the Parents or Guardians of the incident.  I have also advised the Church Board of the incident and will give them a copy of the completed Critical Incident Report as soon as possible.  I will keep a note of when the Church Board was informed.   

A VICTIM IS AN ADULT (over 18 years) – the Adult victim may refuse to report to police

□ The SEX OFFENDER attends or is a member of Mountainview CRC.

□ The SEX OFFENDER does not attend or is not a member of Mountainview CRC.

Adult’s Name: _____________________________          

Date of Incident:  __________________________  Date Reported: __________________________

Address: _________________________________________________________________________

Telephone #:  __________________________

 VICTIM IN IMMEDIATE DANGER AND/OR A PERSON IS DISCOVERED COMMITTING A SEXUAL OFFENCE   PERSONAL STEPS: Contact Police 911.  Call an ambulance if necessary. Find a secure place. Complete below “what was witnessed/disclosed”, namely get a description of assailant or sexual offender, physical description/emotional state of victim and description of the incident (word-for-word if possible). 

VICTIM NOT IN IMMEDIATE DANGER: suggest the Victim contacts police and advise the victim you will go with them, or a designate, to report the matter to police.  Complete below “what was witnessed/disclosed”.

ADULT - WHAT WAS WITNESSED/DISCLOSED - description of assailant/sexual offender, description of physical/emotional state of victim and description of the incident (word-for-word if possible).

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________
FURTHER ACTION NEEDED WHEN THE VICTIM IS AN ADULT: 

1.      Sex Offender Attends/Member of Mountainview CRC:  I HAVE: Suggested the victim contacts Police and advised the victim I will go with them, or a designate, to report to police.  *Advised the victim someone from the Church Board will contact them (they may refuse to report to Police). 

      Advised the Church Board of the incident and will give them a copy of the completed Critical Incident Report as soon as possible.  Note when the Church Board was informed.  Advised the victim of professional agencies and sexual abuse support groups that they can contact to receive help and advice.  Indicate below what professional agencies and sexual abuse support groups were suggested to the victim. 

_________________________________________________________________________________

2.      Sex Offender DOES NOT attend, OR IS NOT a Member of Mountainview CRC. *As #1 above but

OMIT “someone from the Church Board will contact them.” 

The Critical Incident Response form completed on ___________________________________(Date)

Name: _____________________________ Signature: __________________________________

APPENDIX B
LETTER OF CONSENT TO ALLOW A SEX OFFENDER TO ATTEND MOUNTAINVIEW CRC     
(This is a Sample letter as approved by the Church lawyer) 

APPLIED TO AN ADULT (AGED 18 AND OVER) who is a member of Mountainview Christian Reformed Church and who is a victim of a SEX OFFENDER described as follows:

SEX OFFENDER: When a Member of Mountainview Christian Reformed Church is Charged with a Sexual Offence and is out on Bail; or when a member is on Probation following time in custody; or when a person who is on the Sex Offender Registry asks to attend the church, or is found to be attending, or requests membership in the church.

As an Adult Victim of     XXXXXXXXXXXXXXXXXXXXXXXXXXXXXX, a Sex Offender described as above, 

I have been interviewed by a Church Board member and the Lead Pastor and have been asked if I am willing to have this sex offender attend the church.  

I understand that the offender has repented, is aware of the hurt they have caused, and is/has been in counselling.   *i) See Note below if Covenant is available.

A.     I, the undersigned, HEREBY CONSENT to the offender being allowed on church property and/or to participate in church sponsored events at Mountainview Christian Reformed Church.

Date: _________________________________ 

Name: _________________________________        Signature: _____________________________

B.      I, the undersigned, DENY CONSENT to the offender being allowed on church property and/or to participate in church sponsored events at Mountainview Christian Reformed Church.

Date: _________________________________ 

Name: _________________________________        Signature: _____________________________

Note: i) When a Covenant is available and signed, we will give or show a copy to the victim, and the following will be added instead of the previous line:

•      I understand that the offender has signed and agreed to abide by the provisions of the Accountability Covenant.  The offender has repented, is aware of the hurt they have caused, and is/has been in counselling. 
•      I have read the Accountability Covenant signed by the offender. 

Note: ii) See 1.2 INTEGRATION/RETURN TO CHURCH, 1.2 (i), 1.2 (ii)                                                   

APPENDIX C           
ACCOUNTABILITY COVENANT – SEXUAL OFFENDERS FOR THOSE WHO HAVE BEEN CHARGED, RELEASED ON BAIL, CONVICTED AND/OR ARE ON PROBATION, AND/OR ARE ON THE SEX OFFENDER REGISTRY  
(This is a Sample letter individual covenants MUST BE approved by the Church lawyer)

As a sex offender who has received Jesus Christ’s forgiveness and been baptized, for the benefit of the church and its members, staff and officers, I agree to the following terms and conditions.  As a person of faith, I promise Mountainview CRC that I will adhere to the following guidelines for the protection of children, young persons, vulnerable persons and the Church members.  

** IT IS EXTREMELY IMPORTANT THAT EVERY COVENANT
IS TAILORED TO AN INDIVIDUAL SEXUAL OFFENDER  

MY ACCOUNTABILITY COVENANT 

Name:  ___________________________________________   Date: ____________________________

Signature:  ___________________________________________

CHAIR OF CHURCH BOARD

Name:  ___________________________________________   Date: ____________________________

Signature:  ___________________________________________

CHAIR OF PASTORAL ELDERS

Name:  ___________________________________________   Date: ____________________________

Signature:  ___________________________________________

CHAIR OF PASTORAL DEACONS

Name:  ___________________________________________   Date: ____________________________

Signature:  ___________________________________________

APPENDIX D           
AUTHORIZATION FOR RELEASE OF PERSONAL INFORMATION, AND PERMISSION TO REQUEST A POLICE VULNERABLE SECTOR CHECK (PVSC) 
(This is a sample form as approved by the Church lawyer)

For Alleged sex abuse but no charges have been laid against the person involved

As a person who has received Jesus Christ’s forgiveness and been baptized, and as there is an allegation of sexual abuse, and for the benefit of the church and its members, staff, and officers I, the undersigned, hereby authorize Mountainview Christian Reformed Church to:

Receive Authorization for Release of personal information, and Permission to Request a Police Vulnerable Sector Verification Check (PVSC).        

Signing this Authorization for Release of Personal Information in no way constitutes a presumption or confession of guilt. 

By signing below this constitutes my explicit consent to disclose personal information relating to the Authorization for Release of Personal Information and Permission to Request a PVSC form. 

Date: _________________________________ 

 Name: ______________________________              Signature: _____________________________
                               (full name)

Please return this Authorization for Release of Personal Information to the following address:
Mountainview Christian Reformed Church, 290 Main St. East, Grimsby, Ontario, L3M 1P8

APPENDIX E
SAMPLE OFFENDER LETTER

The Offender Denied Attendance at Mountainview CRC - Sexual offence(s) committed against a child, young person, or vulnerable person who attends, or is a member of Mountainview CRC. *See (i) and (ii) below.

Dear Xxxxxxxxxxxxxxx

It is with great sadness and heaviness of heart that we are writing to you today.  The Mountainview Christian Reformed Church affirms the dignity and worth of all persons.  We are committed to being a religious community open to those who choose to worship with us, especially in times of serious personal troubles.  However, we are sorry to say that we can no longer do so in your case as we have grave concerns about your contact with children, young persons, and vulnerable persons.  

It is with regret that we must notify you that your attendance on Mountainview Christian Reformed Church property or participating in a church sponsored event will no longer be allowed.  However, it is our wish that, upon repentance, we may be able to work with you towards an alternative form of worship/fellowship.  For example, you may wish to be part of a small accountability support group who have your best interests at heart and would meet regularly with you to help in your spiritual growth and faith.  Or, the Lead Pastor could help in finding you another appropriate place of worship.  Bear in mind that it is our duty to fully inform your new church of your situation.  

We do hope that you will continue to study God’s Word and pray, and that you may come to an understanding of the foundations supporting our decisions.

Sincerely
Chair of Church Board *Note: 

i)        Offence(s): alleged – while an investigation is taking place, charged and/or on bail, on probation/parole order, and/or on Sex Offender Registry. 
ii)      If a child, young person, or vulnerable victim of the sex offender attends church services at our church, or is a member of the congregation, the offender shall not be permitted on church property or to participate in church sponsored events.

APPENDIX F            
SAMPLE OFFENDER LETTER

The offender is CHARGED and OUT on BAIL.  The victim DOES NOT attend Mountainview church services, and/or is NOT a member of Mountainview CRC.

Dear Xxxxxxxxxxxxxxx

The Mountainview Christian Reformed Church affirms the dignity and worth of all persons.  We are committed to being a religious community open to those who choose to worship with us, especially in times of serious personal troubles.  However, based on your recent sexual offence charges, we have grave concerns about your contact with children, young persons and vulnerable persons.  Therefore,

you are denied access to church property or participating in church sponsored events at Mountainview Christian Reformed Church until further notice.

At the same time, we believe that it is important, as a Christian community, to continue to deal with the one who has offended within the grace of our Lord, in which we all live. *(i) see below if this applies.

Knowing that God’s grace has been extended to all, that grace invites repentance and that repentance requires acknowledgement of sin, and a turning away from sin, all with the support and prayers of God’s people.  We determine to provide a means that a sex offender can live in that grace in the life of this congregation, and an Accountability Covenant outlining restrictions would need to be signed by you before participating in the church. 

Signing a Covenant will in no way constitute a presumption or confession of guilt.  This is a routine safety precaution, activated without prejudice toward particular individuals or circumstances in order to protect you from further suspicion.  

Secrecy about situations within the church may encourage abuse - transparency makes everyone safer.  The identity of a sex offender will not be kept a secret in our congregation.  Therefore, details of the charges against you, and your Bail terms and conditions will be made available to the Mountainview Christian Reformed Church members.   

The Authorization for Release of Personal Information form is attached to this letter and must be signed, dated and returned to Mountainview Christian Reformed Church in order that we can consider drafting an Accountability Covenant.   We require the items below.

-          Authorization for Release of Personal Information on Charges and Bail Order to obtain their terms and conditions.  We also require the name and telephone number of your lawyer.
-          Authorization for Release of Personal information on Charges, Bail Order to obtain their terms and conditions.  We also require the Covenant to all members of Mountainview Christian Reformed Church.

Sincerely,
Chair of Church Board

*A small Accountability Support Group will be established to give you spiritual care and guidance.

APPENDIX G           
SAMPLE OFFENDER LETTER 
The offender is on PROBATION/PAROLE ORDER and/or on the SEX OFFENDER REGISTRY and is a member of Mountainview CRC.  The victim does not attend church services and is NOT a member of Mountainview CRC.

Dear Xxxxxxxxxxxxxxx

The Mountainview Christian Reformed Church affirms the dignity and worth of all persons. We are committed to being a religious community open to those who choose to worship with us, especially in times of serious personal troubles.  However, based on your recent sexual offence charges, we have grave concerns about your contact with children, young persons and vulnerable persons.  Therefore,

you are denied access to church property or participation in church sponsored events at Mountainview Christian Reformed Church until further notice.

At the same time, we believe that it is important, as a Christian community, to continue to deal with the one who has offended within the grace of our Lord, in which we all live. *(i) see below if this applies.

Knowing that God’s grace has been extended to all, that grace invites repentance and that repentance requires acknowledgement of sin, and a turning away from sin, all with the support and prayers of God’s people.  We determine to provide a means that a sex offender can live in that grace in the life of this congregation, and an Accountability Covenant outlining restrictions would need to be signed by you.  Signing a Covenant will in no way constitute a presumption or confession of guilt.  This is a routine safety precaution, activated without prejudice toward particular individuals or circumstances in order to protect you from further suspicion.  

Secrecy about situations within the church may encourage abuse - transparency makes everyone safer. 

The identity of a sex offender will not be kept a secret in our congregation.  Therefore, information on Probation/Parole Order, Sex Offender Registry (Prohibition Order) - their terms and conditions, and the Covenant will be made available to All the Mountainview Christian Reformed Church members.   

The Authorization for Release of Personal Information form is attached to this letter and must be signed, dated and returned to Mountainview Christian Reformed Church in order that we can draft an Accountability Covenant. 
-          Authorization for Release of Personal Information on Probation or Parole Order, and Sex Offender Registry (Prohibition Order) to obtain their terms and conditions.
-          Authorization to Contact your Probation/Parole officer to corroborate terms and conditions, and the Probation/Parole officer’s name and telephone number.
-          Authorization for Release of Personal information on Probation/Parole Order, Sex Offender Registry (Prohibition Order) to obtain the terms and conditions, and the Covenant, to All members of Mountainview Christian Reformed Church. 

Sincerely
Chair of Church Board

*A small Accountability Support Group may continue to give you spiritual care and guidance. 

APPENDIX H           
SAMPLE OFFENDER LETTER

The offender is ONLY on the SEX OFFENDER REGISTRY (Prohibition Order). A VICTIM of the offender DOES NOT attend the church services or is NOT a member of Mountainview CRC.

Dear Xxxxxxxxxxxxxxx

The Mountainview Christian Reformed Church affirms the dignity and worth of all persons.  We are committed to being a religious community open to those who choose to worship with us, especially in times of serious personal troubles.  However, based on your recent sexual offence charges, we have grave concerns about your contact with children, young persons and vulnerable persons.  Therefore,

you are denied access to church property or participation in church sponsored events at Mountainview Christian Reformed Church until further notice.

At the same time, we believe that it is important, as a Christian community, to continue to deal with the one who has offended within the grace of our Lord, in which we all live. *(i) see below if this applies.

Knowing that God’s grace has been extended to all, that grace invites repentance and that repentance requires acknowledgement of sin, and a turning away from sin, all with the support and prayers of God’s people.  We determine to provide a means that a sex offender can live in that grace in the life of this congregation, and an Accountability Covenant outlining restrictions would need to be signed by you.  Signing a Covenant will in no way constitute a presumption or confession of guilt. This is a routine safety precaution, activated without prejudice toward particular individuals or circumstances in order to protect you from further suspicion.  

Secrecy about situations within the church may encourage abuse - transparency makes everyone safer.  The identity of a sex offender will not be kept a secret in our congregation.  Therefore, details of the charges against you, and your Bail terms and conditions will be made available to the Mountainview Christian Reformed Church members.   

The Authorization for Release of Personal Information form is attached to this letter and must be signed dated and returned to Mountainview Christian Reformed Church in order that we can consider drafting an Accountability Covenant.
-             Authorization for Release of Personal Information on sexual offence charges, time spent in custody and the Sex Offender Registry (Prohibition Order) terms and conditions. 
-             Authorization for Release of Personal information on the sexual offence charges and Sex Offender Registry (Prohibition Order) terms and conditions and the Covenant, to All members of Mountainview Christian Reformed Church. 

Sincerely
Chair of Church Board

*A small Accountability Support Group will be established to give you spiritual care and guidance.

APPENDIX I             
AUTHORIZATION FOR RELEASE OF PERSONAL INFORMATION CHARGED AND OUT ON BAIL
(This is a sample form as approved by the Church lawyer)

As an alleged sex offender who has received Jesus Christ’s forgiveness and been baptized, for the benefit of the church and its members, staff and officers, I, the undersigned, hereby authorize Mountainview Christian Reformed Church to:

Receive/Release personal information to the Church Board on the Charges and the Bail Order terms and conditions.

Receive the name and telephone number of my lawyer.

Release personal information on Charges, Bail Order terms and conditions, and a Covenant to All members of Mountainview Christian Reformed Church.

By signing this authorization for release of personal information I in no way constitute a presumption or confession of guilt. 

By signing below this constitutes my explicit consent to disclose personal information relating to the Authorization for Release of Personal Information form. 

Date: _________________________________ 

Name: ______________________________              Signature: _____________________________
                               (full name)

Please return this Authorization for Release of Personal Information to the following address:
Mountainview Christian Reformed Church, 290 Main St. East, Grimsby, Ontario, L3M 1P8

APPENDIX J            
AUTHORIZATION FOR RELEASE OF PERSONAL INFORMATION PROBATION/PAROLE ORDER, PAROLE OFFICER AND/OR ON THE SEX OFFENDER REGISTRY      
(This is a sample form as approved by the Church lawyer)

 As a sex offender who has received Jesus Christ’s forgiveness and been baptized, for the benefit of the church and its members, staff and officers, I, the undersigned, hereby authorize Mountainview Christian Reformed Church to:

 Receive/Release personal information to the Church Board on Probation or Parole Order, and Sex Offender Registry (Prohibition Order) terms and conditions.

Receive Probation/Parole officer’s name and telephone number to corroborate terms and conditions.

Release of Personal information on Probation/Parole Order, Sex Offender Registry (Prohibition Order) and a Covenant, to All members of Mountainview Christian Reformed Church.

By signing below this constitutes my explicit consent to disclose personal information relating to the Authorization for Release of Personal Information form.

Date: _________________________________

 Name: ______________________________              Signature: _____________________________
                               (full name)

 Please return this Authorization for Release of Personal Information to the following address:
Mountainview Christian Reformed Church, 290 Main St. East, Grimsby, Ontario, L3M 1P8

APPENDIX K           
AUTHORIZATION FOR RELEASE OF PERSONAL INFORMATION ONLY ON SEX OFFENDER REGISTRY  (This is a sample form as approved by the Church lawyer)

As a sex offender who has received Jesus Christ’s forgiveness and been baptized, for the benefit of the church and its members, staff and officers, I, the undersigned, hereby authorize Mountainview Christian Reformed Church to:

Receive/Release personal information to the Church Board on the sexual offence charges, time spent in custody, and the Sex Offender Registry terms and conditions.  

Release of Personal information on the Sexual Registry (Prohibition Order) terms and conditions, and a Covenant, to All members of Mountainview Christian Reformed Church Christian Reformed Church members.

By signing below this constitutes my explicit consent to disclose personal information relating to the Authorization for Release of Personal Information form.

Date: _________________________________ 

Name: ______________________________             Signature: _____________________________  (full name)

 Please return this Authorization for Release of Personal Information to the following address:

Mountainview Christian Reformed Church, 290 Main St. East, Grimsby, Ontario, L3M 1P8

APPENDIX L            
SAMPLE FIRST LETTER TO CHURCH MEMBERSHIP 

When it is known there are sexual offence charge(s)/counts against a Member of Mountainview CRC.

Dear Member of Mountainview Christian Reformed Church

 We were recently made aware that a member of Mountainview Christian Reformed Church is charged with a sexual offence(s) in Canada and has been released on a Bail Order.  It is because of this that the Church Board is encouraging parents to speak, with sensitivity, to their children and/or young people asking if anything sexually inappropriate has happened to them while participating in the ministries of Mountainview CRC.         

Secrecy about situations within the church may encourage abuse - transparency makes everyone safer.  The identity of the sex offender will not be kept a secret in our congregation.  

 Xxxxxxxxxxxxxxxxxxxxxxx has been charged with xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx. * (i) see below.  The Bail conditions are xxxxxxxxxxx xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx, xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx, 

Knowing that children, young persons and vulnerable persons are at risk and do not have the ability to protect themselves, we are determined to provide protection for them.  The devastating effects of sexual abuse require us to treat anyone who has offended in this way with unwavering caution.  Therefore, Xxxxxxxxxxxxxxxxx has been denied access to church property or participation in church sponsored events at Mountainview Christian Reformed Church until further notice.  

*(ii) see below

At the same time, we believe that it is important, as a Christian community, to continue to deal with the one who has offended within the grace of our Lord, in which we all live.  *(iii) see below

There will be an Information Meeting for members of Mountainview Christian Reformed Church on xxxxxxxxxxxxxxxxxxxxxxxx

Sincerely
Chair of Church Board

 *Note: The following can be added to the letter if they apply:
i)        The offender may not be released at this point, or we are waiting to receive the bail conditions from the offender and/or their lawyer.
ii)      The victim(s) - if it involves a member(s) of Mountainview C.R.C., the third paragraph will state “Spiritual care, professional counselling and multiple resources will be provided to the victim for continued healing”.
iii)    A small Accountability Support Group will be established to give Xxxxxxxxxxxxxxxx spiritual care and guidance.

APPENDIX M          
SAMPLE SUSPENSION OR DISMISSAL LETTER TO OFFENDER

Letter for an offender who refuses to sign a Covenant, OR is in violation of the Covenant terms and conditions but HAS NOT committed a criminal offence.

Mr. Xxxxxxxxxxxxx
Xx  xxxxxxxxxxxxxxx  xxxxxxxxxx,
Xxxxxxxxxxxxxx, Xxxxxxxxxxxx

Dear Xxxxxxxx

It is our desire to missionally receive all people to worship here at Mountainview Christian Reformed Church.  However, we are sorry to say that we can no longer do so in your case. We wish you the best, but we are not comfortable with you attending our church property or participating in church sponsored events.

It has come to our attention that you are not readily falling under the authority of the church and continue to try to work around our system.  Your refusal to sign our Covenant, disagreement with our Covenant and protocols (even the need for a Covenant and protocols), as well as reluctance to accept responsibility and the consequences for your actions, lead us to believe that your participation here at Mountainview Christian Reformed Church poses a greater risk to the church and the congregation than we are willing to allow.  It is with regret that we must notify you that your attendance at Mountainview Christian Reformed Church property or participation in church sponsored events will no longer be allowed.

We do hope that you will continue to study God’s Word and pray, and that you may come to an understanding of the foundations supporting our decisions.

Sincerely 

Xxxxxx Xxxxxx
Chair of Church Board

APPENDIX N           
SAMPLE FOR PROBATION/PAROLE ORDER OFFICER(S)

Letter for an offender who refuses to sign a Covenant OR is in violation of the Covenant terms and conditions but HAS NOT committed a criminal offence.

Ministry of the Solicitor General
Xxxxxx Parole Office
Xxxxx Xxxxxxxx Street, Xxxxx, XX Xxxxx

Dear Mr. Xxxxxx
Subject: xxxxxxxxxxxxxxxxx

 Xxxxxxxxxxxxx has been attending services at Mountainview Christian Reformed Church.  This letter will serve to notify you that we have advised Xxxxxxxxxxxxxxxxxxx that we are no longer comfortable allowing him/her to attend church property or participate in church sponsored events at Mountainview Christian Reformed Church in Grimsby. 

 Please know that as far as we are aware, Xxxxxxxxxxxxxx has not violated any terms of probation/parole in his/her attendance at Xxxxxxxxxx.  

 Xxxxxxxxxxxxxxxxx has not, however, readily fallen under the authority of the church or our additional requirements (Covenant) for their participation.  Our duty to our congregation, in this case, outweighs our duty to Xxxxxxxxxxxxxxx

 If you have any questions, please feel free to call us at Xxxxxxxxxxxxxxxx.

Yours sincerely
Xxxxxx Xxxxxx
Chair of Church Board