Counselor Registration

I hereby certify that the information I have provided in this application is true and complete. I authorize State Line Baptist Church to verify the information I have provided on this application by contacting the references, and churches I have listed, by conducting a criminal records check, or by other means, including contacting others whom I have not listed. I authorize the references and employers listed in this application to give the church whatever information they may have regarding my character and fitness for the job for which I have applied. Furthermore, I waive any rights I may have to confidentiality.
In consideration of the receipt and evaluation of this application by State Line Baptist Church, I hereby release any individual, church, youth organization, charity, employer, reference, or any other person or organization, including record custodians, both collectively and individually, from any and all liability for damages of compliance or any attempts to comply, with this authorization.
Should my application be accepted, I agree to abide by and be bound by the policies and the moral and spiritual teaching of New England Baptist Teen Camp, a group sponsored by State Line Baptist Church, and to refrain from unscriptural conduct in the performance of my duties on behalf of the New England Baptist Teen Camp, State Line Baptist Church, and its ministries.
I have read this waiver and the entire application, and I am fully aware of its contents. I sign this consent freely and under no duress or coercion. I understand that any omission or misinformation in the application may result in the rejection of my application or my dismissal from service if I have already been given my position.
I also consent to the use of this digital form, and my name in the field below represents my signature.