CONSENT FOR CRIMINAL BACKGROUND CHECK
I hereby give my permission for The Family Place to obtain information relating to my criminal history through the Volunteer Center of Dallas County. The criminal history record, as received from the reporting agencies, may include arrest and conviction
data as well as plea bargains and deferred adjudication's and delinquent conduct committed as a juvenile. I understand this information will be used, in part, to determine my eligibility for a volunteer position with The Family Place. I also understand
that as long as 1 remain a volunteer here, the criminal history records check may be repeated at any time. I understand that I will have the opportunity to review the criminal history as received by The Family Place and a procedure is available for
clarification if I dispute the record as received. I also understand that the criminal history could contain information presumed to be expunged.
I, the undersigned, do, for myself and my heirs, executors and administrator hereby remise, release, and forever discharge and agree to indemnify The Family Place and The Volunteer Center of Dallas County and each of their officers, directors and employees
and agents harmless from and against any and all causes of actions, suits, liabilities, costs, debts and sums of money claims and demands whatsoever (including claims for negligence, gross negligence, and/or strict liability of the Volunteer Center
of Dallas County) and any and all related attorney’s fees, court costs, and other expenses resulting from the investigation of my background in connection with my application to become a volunteer.