The information contained in this application is correct to the best of my knowledge. I authorize any references listed in this application or on my reference forms to give you any information they may have regarding my character and fitness for children/youth work. I release all such references from liability for any damage that may result from furnishing such evaluations to you and I waive any right that I may have to inspect references provided on my behalf.

I release Chicago Lights and/or Fourth Presbyterian Church to verify the truthfulness of any of the above information through past employers, personal references, criminal record checks, or other appropriate investigation. I further release Chicago Lights and/or Fourth Presbyterian Church to share any of the above information with any agent of Chicago Lights (whether paid staff or volunteer staff) when necessary to evaluate my acceptance or continuation as a volunteer in the programs.

I authorize and consent to Chicago Lights and/or Fourth Presbyterian Church’s thorough investigation of whether I have been indicated of being involved in any aspect of child abuse, and, if so, the nature of the circumstances available through lawful means. A background check will focus on convictions or any involvement in child abuse. A criminal record may not necessarily disqualify me from volunteering.

I understand that while Fourth Presbyterian Church and Chicago Lights will utilize all reasonable safety precautions, I release Fourth Presbyterian Church and Chicago Lights from any liability and assume full responsibility for myself at all times.

I understand that Chicago Lights and Fourth Presbyterian Church neither endorses nor sponsors off-site, independent relationships and activities between volunteers and students. If such relationships and/or activities occur independent of the on-site programming sessions, Chicago Lights and Fourth Presbyterian Church are not responsible for accidents and/or incidents arising from such events. Volunteers and parents/guardians of students are responsible for communicating directly with each other to navigate offsite relationships, using all reasonable safety precautions including, but not limited to: initial volunteer and parent/guardian meeting, volunteer obtaining written permission from the parent/guardian of the students for any off-site outing, and volunteer and parent/guardian agreeing to and planning outings in public, safe environments.

Should my application be accepted, I agree to be bound by the Constitution and Bylaws and Policies of Fourth Presbyterian Church and the Chicago Lights, and to refrain from unlawful conduct in the performance of my services on behalf of the church.