Fgfa Background Check Authorizarion Form printable pdf download

FGFA BACKGROUND CHECK AUTHORIZATION

I understand that in processing my application with Farmington Girls Fastpitch Association

(FGFA), an investigative consumer report may be conducted to obtain and verify information

relating to my past activities and background. Information may include, but is not limited to;

criminal records, motor vehicle records, and any data provided on this application, or during the

interview process.

I authorize the appropriate individuals, companies, institutions or agencies to release information,

and I release them from any liability as a result of such inquiries or disclosures.

I further understand and waive my right of privacy in this investigation and release and hold

harmless Farmington Girls Fastpitch Association and its approved background check agent, from

any liability.

I hereby certify that all the statements and answers set forth on the application form are true and

complete to the best of my knowledge, and I understand that if any statements and/or answers

are found false or the information has been omitted, such false statements or omissions may be

cause for rejection or termination of my volunteer activities or application.

For FGFA, or our approved background check agent, to run a background check on you, please

provide all of the following information. All of this information is REQUIRED. A passed

background check is required before a coach may take the field with players.

First Name:______________________________________

Last Name:_______________________________________

Address:__________________________________________

City:_______________________________________________

State:______________________________________________

Zip Code:__________________________________________

Phone: _____________________________________________

Gender:_____________________________________________

Date of Birth:_______________________________________

Email:_______________________________________________

Drivers License Number

(all letters and numbers):___________________________

Drivers License State:______________________________

Drivers License Expiration Date:___________________

I authorize a photocopy or electronic copy of this release to be accepted with the same authority

as the original and if employed by the above named organization. This release will remain in

effect throughout such engagement

________________________________________________________________________

Signature

Date

Fgfa Background Check Authorizarion Form