Risk Management Forms – Safe Environment

Contact

John Polkinghorn, Director of Risk Management
Phone: (605) 988-3718
Fax: (605) 988-3723
Email: jpolkinghorn@sfcatholic.org

Risk Management Curriculums in CMG Connect

Risk Management curriculums are designed for employees, volunteers, managers, and administrators. Topics include defensive driving, finance practices, building safety, festival safety, and sexual harassment. If you are currently an employee or volunteer at a parish, Catholic school or diocesan organization, please sign-in to the same CMG Connect account you use for Safe Environment. If you do not have a CMG Connect account, please create a new account. If you need assistance, please contact the Safe Environment Office.

Forms

Consent Forms

You t h Ministry Parental Consent Form (One Day): completed by parent/guardian when their minor child will be participating in a single day activity. The completed form should be securely filed at the diocesan facility for three years after the participants’ 18th birthday.
Youth Ministry Parental Consent Form (Overnight): completed by parent/guardian when their minor child will be participating in an overnight activity. The completed form should be securely filed at the diocesan facility for three years after the participants’ 18th birthday.

Facility Use Forms

The Facility Use Policy and Facility Use Application is provided to anyone who is interested in using diocesan facilities for their event. After the pastor or agency administrator has reviewed and approved the completed Facility Use Application, the person needs to complete the Facility Use Agreement and provide a certificate of liability insurance.

Homeowners may be able to obtain this liability insurance through their homeowner’s policy. If a homeowner is able to obtain the required liability coverage stated in the Facility Use Agreement, it is important that the certificate of insurance lists the name of the facility and the diocese as “additionally insured” (How do I know if my parish is listed as “additionally insured” on the liability insurance certificate?).

If the person is unable to obtain liability insurance through a homeowner’s policy, the person may complete the Special Events Application to obtain the required liability insurance needed for their event.

Liability Waiver Form

Adult Liability Waiver: completed by adults, aged 18 or older, who are planning to participate in a parish or school event involving youth, including group leaders and chaperones. The completed form should be securely filed at the diocesan facility for three years after the date of the event.

Report an Accident or Property Damage

Report Property Damage: used to report property damage at a parish, school, or other diocesan agency.
Report a Non-Employee Accident: used to report non-employee accidents that occur on parish, school, or a diocesan agency’s property.
Report an Employee Accident: accidents involving employees should be reported to the Human Resources department.

Volunteer Driver Application

Volunteer Driver Application: completed by all adults who drive on behalf of a diocesan organization. The completed form should be securely filed at the diocesan facility for three years. Adult drivers are also strongly encouraged to sign-in to their CMG Connect account to complete the Defensive Driving Curriculum.