This form is to be completed by any applicant who is involved with Bethel Deliverance International Church children and youth ministries. We recognize this form is extensive, but ask for your patience in completing the form in its entirety. Your cooperation will assist the church leaders in their efforts to provide a secure environment for you as well as the children and youth who participate in our ministry programs and use our facilities. Your responses will be maintained confidentially, although there may be circumstances where such information may be provided on a "need to know" basis to individuals working with our ministry and to other individuals in order to evaluate your application and/or comply with applicable legal requirements.
NOTE: If you live in a state where laws exempt you from providing any of the information requested, you need not answer the questions requesting requesting such information. For example, you need not disclose information that is constrained in sealed or expunged court records, or that involves a criminal arrest that did not result in conviction.
The response I have provided in completing this application form are complete, truthful and accurate. I hereby authorize Bethel Deliverance International Church (hereinafter referred to as "the Church") to make inquiries concerning my background in connection with evaluating the information I have provided on this form and in the application process, including criminal record checks if deemed necessary by the Church. I hereby authorize all persons associated with me, including churches, employers, law enforcement agencies, licensing and social service agencies to release any information contained in their files or records concerning me to the Church and its representatives.
In consideration of the receipt and evaluation of this application form by the Church, I hereby release Bethel Deliverance International Church, Inc. and their directors, employees, agents, representatives and any other person or organization, including record custodians, that may release information concerning me. I also hereby release the Church 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 inquiries concerning my background and any disclosures of information concerning me to Bethel Deliverance International Church, Inc.