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Criminal History Consent

All staff and volunteers must complete this form.

I understand that Agape Therapeutic Riding Resources will conduct a criminal history background check when processing my volunteer and/or employment application to include a search for criminal records in my counties of residence. Further, I understand that Agape Therapeutic Riding Resources will conduct an investigation to verify my social security number and information about past employment.

I also understand that before I am denied participation in the volunteer program based on information obtained in this investigation, I will receive a copy of the findings and a written description of my rights under the Fair Credit Reporting Act.

I understand if I disagree with the accuracy of any information in the findings, I must notify Executive Director of Agape within three (3) business days of receipt of the report in order to qualify for an opportunity to address the information contained in the criminal history/background check.

I understand that the information contained in the criminal history/background check will be available to the person(s) involved in performing the criminal history/background checks and to the person(s) making volunteer and/or employment assignments and that this information will be used for the purpose of making decisions concerning volunteer and/or employment participation and assignments.

I HAVE FULLY READ AND FULLY UNDERSTAND THIS Consent Form for a Criminal Background Check. I UNDERSTAND THAT, BY SIGNING THIS DOCUMENT, I MAY BE WAIVING AND RELEASING CERTAIN IMPORTANT RIGHTS WHICH I MIGHT HAVE IF I DID NOT SIGN THIS AGREEMENT. I AM SIGNING THIS DOCUMENT VOLUNTARILY AND WITHOUT ANY COERCION.
Type Name of Adult Signing(Required)
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