I hereby give my permission for Hope Presbyterian Church and Criminal Information Services, Inc. to obtain information relating to my criminal history record. The criminal history record, as received from the reporting agencies, may include arrest and conviction data as well as plea bargains and deferred adjudication. I understand that this information will be used, in part, to determine my eligibility for a position within this organization. I also understand that as long as I remain in the capacity of a servant, volunteer, church employee, or church officer, the criminal history records check may be repeated at any time. I have been informed that I will have an opportunity to review any reports and that a procedure is available for clarification if I dispute the record as received. *

I agree.

I, the undersigned, do, for myself, my heirs, executors and administrators, hereby remise, release, and forever discharge and agree to indemnify Hope Presbyterian Church and each of their officers, directors, employees, and agents harmless from and against any and all causes of actions, suits, liabilities, costs, debts, and sums of money, claims and demands whatsoever, and any and all related attorney’s fees, court costs, and other expenses resulting from the investigation of my background in connection with my application to Hope Presbyterian Church. *

I agree.

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I hereby affirm that all information on this form is true and accurate to the best of my knowledge. By clicking the 'Submit' button below, I subscribe my electronic signature to this form by means of a timestamp.