Finding Freedom on the Inside

Clearance Forms

Cornerstone Prison Church meets inside the walls of the South Dakota State Penitentiary.  To comply with DOC regulations, all visitors must provide the information needed for the DOC to run background checks.  If you would like to visit, please fill out the following form completely and accurately.  The link is a pdf that you can print and fill out by hand.  Please return it to Cornerstone Prison Church by scanning and email if you are able.  

Each person must complete the following: 


DOC Access Info and Liability Waiver


Please Note: This is a 3 page document. All 3 pages must be filled in accurately and completely, one person per form.

  1. Pages one and two are the information that the DOC needs to process a security check.  
  2. Page three is a state liability release waiver.  (The prison may ask for this to be signed again at the time of entry.)