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Liability Waiver and Consent to Procurement of an Investigative Background Report
I understand that, as a condition of consideration for employment and/or volunteer work with Crossroads Nazarene Church, or as a condition of continued employment and/or volunteer work with Crossroads Nazarene Church, Crossroads Nazarene Church may obtain a background report that includes, but is not limited to, employment and education verification, social security number verification, criminal and civil court history, personal interviews, driving records, and any other public records or any other information bearing on my character, general reputation, personal characteristics, and trustworthiness.
I hereby authorize and consent to Crossroads Nazarene Church’s procurement of such a report and acknowledge that such report may be prepared by a third party to be selected by Crossroads Nazarene Church. I understand that, pursuant to the federal Fair Credit Reporting Act, Crossroads Nazarene Church will provide me with a copy of any such report if the information contained in such report is, in any way, to be used in making an adverse decision regarding my fitness for employment or volunteer work with Crossroads Nazarene Church. I further understand that such report will be made available to me prior to such decision being made, along with the source of the information contained in the report.
I agree to release from liability and damages Crossroads Nazarene Church and its agents who conduct and participate in any such review and those individuals, organizations, and their agents who provide information about me during this review, only to the extent that such information is released without malicious intent. I authorize all such persons to treat a photocopy of this Consent as though it were an original, executed consent. All materials pertaining to the background report shall be the property of Crossroads Nazarene Church.
I attest and affirm that all of the information I have provided is true, complete, and correct. I agree to abide by the policies and procedures of Crossroads Church of the Nazarene and to protect the health and safety of the children or youth at all times.
I agree to submit this form by electronic means. I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature. I understand that I am not required to sign this form electronically and can request to sign a paper copy if I so choose.