You are on page 1of 4

2277 Rosecrans St, San Diego, CA 92106

619.226.ROCK

Mid Week Home Groups
Why: Life change happens through relationships. Home groups make our large youth ministry feel smaller. It provides
a safe place for students to connect with other students and an adult youth worker and to grow in Christ through prayer
and the Word. It gives students, families and our volunteers a way to be a part of an active church body and it’s a
vehicle for reaching out to all of San Diego. It is also a ton of fun.

What’s Required:
• Have a living space that can accommodate 10-15 students and 2-3 adults
• 10 month commitment, one night a week (September through June) (Holidays off)
• Commit your space from 6:30-8:30 PM on that night
• Completed and accepted Host Home application
• Cleared CIA background check for every adult living in the home

Frequently asked questions:
1. Do I have to be there as the host?
This is up to you. You don’t have to be home or present in the room during group time. You may
choose to spend that two hours in another part of the home. As a courtesy to your guests we ask
that household distractions be minimized. Take the dog outside, turn off cell phones, have younger
children play in their rooms, etc…

2. What else besides my living room do you need?
We only need a large enough space to meet with students. It would be great if you have a television
set and DVD player and could show movie clips or play music. Providing your kitchen to clean up
snacks or to eat food at your table is up to you.

3. I don’t have enough chairs to fit that many people in my house?
Not a problem. Students can sit on the floor. We’ll make sure they don’t sit on the coffee table or
the entertainment system.

4. What times will you need our house, rec room, patio area, etc?
Our leaders will show up around 6:30 PM for a leader meeting. All students will be gone by 8:30
PM unless they belong to you. Leaders will be sure that all litter and is picked up and your home is
back in order.

5. Why do I need a background check for everyone over 18 in my house?
We need to provide a safe environment to protect our students and leaders.

6. What day of the week?
We know that your life is busy, so we have both Tuesday and Wednesday from which to choose to
allow your house to be used to serve God. It’s your choice.

7. Will my house be safe?
Next question please. We handpick our leaders to be sure that the students and your home are safe
and secure. Our leaders go through an extensive training and interview process to serve in the
ministry. If at any time you are displeased with the way your home is being used please call the
Youth Ministry.

What you need to do next:
• Fill out the Application and Background check completely and return it to the Youth Ministry
• We will contact you if your home is considered appropriate for our mid-week ministry
• We will ask that you attend our Host Home orientation
• In January we will begin our Home Groups!
2277 Rosecrans St, San Diego, CA 92106
619.226.ROCK

Host Home Application
General Information

Name: Today’s date:
Address: City, zip:
Email address: Phone day:
Occupation: Phone night:
Employer: Birth date:
Work Status: q part time q full time q student
Marital Status: q single q married q divorced
Do you have a student in q Junior High q Senior High q No student
Name of student: Name of School:

Information about your home
Group desired: q High School q Junior High q Either
Nights Available (Check all that apply): q Tuesday q Wednesday q Thursday
Describe the meeting space (Rooms available, dimensions, foosball, etc.)

Legal and Lifestyle Concerns
In caring for students, we believe it is our responsibility to seek an adult staff that is able to provide healthy, safe and nurturing
relationships. Please answer the following questions accordingly. Any special concerns can be discussed individual with the pastoral
staff.
Are you using illegal drugs?
Have you ever gone through treatment for alcohol or drug abuse?
If yes, please describe.
What is your view on drinking alcohol?
Is alcohol accessible in your house?
If yes, are you willing to move it to a discreet area?
Have you ever been arrested and / or convicted of a crime?
If yes, please describe.
Have you ever had sexual relations with any minor after you became an adult?
Have you ever been accused or convicted of any form of child abuse
If yes, please describe.
Have you ever been a victim of any form of child abuse?
If yes, would you like to speak to a counselor or pastor?
Do you have any questions/ reservations that we can help answer?

The information contained in this application is correct to the best of my knowledge. I, the undersigned, give my authorization to the
Rock Church or its representatives to release any and all records or information relating to working with minors. The Rock Church
may contact my references and appropriate government agencies as deemed necessary in order to verify my suitability as a youth
worker.

I understand that the personal information in this application will be held confidential by the professional church staff.

Signature: Date:
2277 Rosecrans St, San Diego, CA 92106
619.226.ROCK

Host Home Commitment Sheet
After observation of the ministry, spending time in prayer, and discussing with my family the commitment involved with being a host
home, I choose to commit to the following (and, yes, you have to check them all off):

q I acknowledge the Lordship of Jesus Christ in my life and I have a personal relationship with Him.

q I am committed toward growing and maturing in my relationship with God through quiet times, active attendance at
church, and involvement in accountability with another believer of the same sex.

q I am committed to making choices and living a lifestyle that are both Godly and "above reproach", knowing that my
lifestyle is a model for the students.

q I agree sex is reserved for one man and one woman in a marriage covenant. I will abide by the Rock Church’s PMS Policy.

q If I have any alcohol in the house it will be moved to a discreet location during my commitment period

q I am making a commitment to the youth ministry for at least six months.

q I commit to memorizing the Rock Youth Ministries purpose statement.

Signature: Date:
..
.. 4801 Arapaho Rd, Suite 300
.. Addison, TX 75001
.. Office: 214-382-2727
.. Fax: 214-382-2732
.. www.ciabackgroundchecks.com
..
..
. CLEAR INVESTIGATIVE ADVANTAGE LLC-- RELEASE FORM

The purpose of this form is to notify you that an investigation report will be conducted on
you in the course of consideration for this request:

Company Name: The Rock Church

Company Address: 2448 Historic Decatur Rd. #105, San Diego, CA 92071

Last name: First: Middle:

Maiden name or any aliases used in past

Social Security Number: Birth Date:

Driver’s License Number: State:

Present Address:

City: State: Zip Code:

Please list your last seven years of residence (Include city and state).

In connection with this request, I hereby authorize all corporations, employers, education
institutions, law enforcement agencies, city, state, county, and federal courts, military
services and persons to release information they may have about me to the person or
company with which this form has been filed or their agent, Clear Investigative Advantage,
LLC. This releases the aforesaid parties from any liability and responsibility for collecting
any information.

Applicant’s Signature: ________________________________ Date: ______________

www.ciabackgroundchecks.com