INFO@CALVARYVISALIA.ORG - (559) 687-0220

Calvary Visala
Consent and Waiver Form (Confidential)

In consideration of my role with Calvary Visalia and recognizing the importance of my character being above reproach, I HEREBY CONSENT TO THE FOLLOWING:
I hereby authorize Calvary Visalia to make an independent investigation of my background through Protect My Ministry specifically to release information regarding any record of charges or convictions contained in its files, or in any criminal file maintained on me, whether said file is a local, state, or national file, and including but not limited to accusations and convictions for crimes committed against minors, to the fullest extent permitted by city, county, state, and federal law.
I HEREBY WAIVE, RELEASE, AND HOLD HARMLESS FROM LIABILITY Calvary Visalia, its staff, employees, volunteers, and agents with regard to any decision that it makes on my application for involvement with Calvary Visalia based on the information I provide or that is obtained through the criminal history and background screening process.

I CONSENT to a copy of this Consent and Waiver Form being furnished to any reference that I have provided to Calvary Visalia and to any other person, organization, or entity that Calvary Visalia deems necessary in connection with its investigation of my background, character, or qualifications.






If you answered "Yes" to any of the questions above, please provide a written explanation below.
Please be prepared to discuss your answers with a pastor or overseer. By signing below I agree to immediately inform Calvary Visalia of any subsequent information, including any accusations, convictions, or other occurrences that relate to the areas of inquiry set forth above.

The following information is required for Background Check purposes.