I recognize that Salem Heights Church is relying on the accuracy of the information I provide on the Lay Counselor Renewal Application Form. Accordingly, I attest and affirm that the information I have provided is absolutely true and correct.
I voluntarily release the organization and any such person or entity listed on the Lay Counselor Renewal Application Form from liability involving the communication of information relating to my background or qualifications. I further authorize the organization to conduct a criminal background investigation.
I agree to abide by the policies and procedures of the organization and to protect the health and safety of the lay conselees assigned to my care at all times.