Volunteer Background Check Request

The information contained in this application is correct to the best of my knowledge. I authorize any references or churches listed in this application to give you any information, including opinions that they may have, regarding my character and fitness for working with children, youth or vulnerable adults. In consideration of the receipt and evaluation of this application by St. Luke’s United Methodist Church and St. Luke's Day School, I hereby release any individual, church, youth organization, charity, employer, reference or any other person or organization, including record custodians, both collectively and individually, their heirs and assigns, from any and all liability for damages of whatever kind of nature which may at any time result to me, my heirs, or family, on account of compliance of any attempts to comply, with this authorization. I waive any right that I may have to inspect any information provided about me by any person or organization identified by me in this application. Should my application be accepted, I agree to read and be bound by the attached Child, Youth, and Adult Safety Policy for St. Luke’s United Methodist Church and to refrain from conduct in violation of the attached policies in the performance of my services on behalf of the church. I further state that I HAVE CAREFULLY READ THE FOREGOING RELEASE AND KNOW THE CONTENTS THEREOF AND I SIGN THIS RELEASE AS MY OWN FREE ACT. This is a legally binding agreement which I have read and understand.