BACKGROUND CHECK RELEASE FORM
The information provided is true to the best of my knowledge and belief. I understand that any misrepresentation or false statement made by me in connection with the application or any related documents which are deemed material by Life Springs Church (LSC) shall result in LSC not employing me or, if employed, terminating my employment. I understand and agree that all information furnished in my application and all attachments may be verified by LSC. I hereby authorize all individuals and organizations named or referred to in my application and any background reporting organization to give LSC all information relative to such verification and hereby release such individuals, organizations, and LSC from any and all liability for any claim or damage resulting there from. I hereby acknowledge that I have been informed by LSC that LSC may seek to obtain criminal convictions or arrest records if allowed, in order to assist LSC in making certain decisions. I, my heirs, assigns and legal representatives, hereby release and full discharge LSC its parent and affiliated companies, background reporting organization and the respective officers, directors, shareholders, employees, agents of each.
Full Legal Name
Social Security Number
Date of Birth
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