Background Check, Insurance Permission, & Liability Release Form (To be returned to FARE after completion)
This form serves 4 purposes: 1. A background check authorization, 2. A liability release form for the fair, 3. Permission to submit the background check report to the State Fair of Texas upon their request, and 4. Permission to include you name and Social Security number on our insurance policy.
I hereby authorize Fair and Rodeo Evangelism Inc. to conduct a background check using commercially available services. I understand that if any historical evidence is surfaced that would prohibit my serving with FARE that I will be granted full opportunity to view it and contest it. I further release the State Fair of Texas and its officers, agents, and employees from liability, including for negligence, as it relates to my time of volunteer service at the booth specifically organized and operated by Fair and Rodeo Evangelism Inc. for the 2016 state fair.
_________________________ _________________________ _______________ _____/_____/_________ Print first name Print last name Print middle initial Print date of Birth
___ ___ ___ --___ ___-- ___ ___ ___ ___ SSN
____________________________________________ _________________________ Signature Date __________________________________________________________________________________________________________________
Your privacy is important to us.
We will keep these background checks secure at the office of the ministry.
PLEASE RETURN THIS COMPLETED FORM AS SOON AS POSSIBLE TO THE ADDRESS BELOW.