Dowagiac Union Schools Building Volunteers and/or Chaperones Release Form
The Dowagiac Union School District recognizes that volunteers perform a vital role in supporting and promoting its educational and extra-curricular activities for the benefit of students, staff and the public welfare. In order to take steps necessary to ensure safety for all students and staff, building volunteers are asked to have a Limited Criminal History background check on file each year. This report will be kept on file in the superintendent’s office.

It is the responsibility of the volunteer to work with Local Law Enforcement to clear any items listed on a background check. It shall be the discretion of the building Principal or other designated Administrator to limit the type of volunteering based on information listed on a background check in conjunction with applicable Local and State Laws.

I hereby acknowledge and agree to the following:

I have offered my services as a volunteer to help the Dowagiac Union School District.

I agree to abide by all relevant Board policies and administrative guidelines while serving as a volunteer for the District. I understand that, although I am covered under the District’s liability Insurance policy, I am not covered by its health insurance policy; I am not eligible for worker’s compensation. Should I become ill or suffer an accident while doing volunteer work for the District, I agree that I shall be responsible for any and all hospital and medical charges that may accrue.

I understand further that, as a volunteer, I am not in any manner considered an employee of the district or entitled to any benefits provided to employees. I further release the Board of Education, Individual Board members, it employees and agents from any and all liability for any damages, which may result to me as a consequence of my volunteer services.

At times, I may have care, control or custody of students, other than my own child, out of the direct supervision of a teacher or other school employee and I acknowledge that I am required to demonstrate appropriate decorum, judgment and dress in my capacity as a volunteer.

To obtain a Limited Criminal History background check, please complete and submit this form. The school may request a copy of your driver’s license or other form of identification at the time of background request to ensure accuracy.
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