I hereby authorize all employers, organizations, churches, and other entities and persons identified in this form to release any information contained in their files or records concerning me.
In consideration of the receipt and evaluation of this application by Dream Center of Michigan, I hereby release Dream Center of Michigan and any individual, youth organization, charity, employer, reference, or any other person or organization, including record custodians, both collectively and individually, from any and all liability for damages of whatever kind or nature which may at any time result to me, my heirs, or family, on account of compliance or any attempts to comply, with this authorization.
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.
I understand and agree that it is critical to the mission of Dream Center of Michigan that all employees and volunteers conform to the highest standards of safety and interpersonal conduct. I affirm that I will strictly comply with Dream Center of Michigan's policies and procedures, including those concerning child safety and protection, sexual abuse and misconduct, and interpersonal relationships. I understand and agree that failure by me to abide by such policies and procedures may result in my immediate dismissal, or disciplinary action, all at the discretion of Dream Center of Michigan.
My responses in the foregoing application are truthful and accurate. I understand and agree that if they are not truthful and accurate, Dream Center of Michigan may determine that I am no longer qualified to be associated with its programs as an employee, or volunteer in any capacity. By signing this form, I acknowledge that I waive any right that I may have to inspect any information provided about me by any person or organization in connection with this application.
I give my permission for persons to speak freely regarding their experiences with me.