Please fill out this section to the best of your ability.
Please give two (2) character references with whom you have had sufficient contact over the past five (5) years.
Please do not use CCC's paid staff, members, or relatives.
If you are under the age of 18, please keep in mind that your references must be an adult.
The information contained in this application is correct to the best of my knowledge. I, the undersigned, give my authorization to Country Christian Church or its representatives to release any and all records and information relation to working with minors. The church may also contact my references. I authorize any references listed to give you any information they may have regarding my character and fitness for work with minors. I release all such references from liability from any damage that may result from such evaluations to you and I waive any right to inspect these references.
I authorize Country Christian Church to perform a criminal records check for arrests, convictions, or other information to the Department of Corrections and any other local, state or federal criminal enforcement agency may have regarding me and release such information to Country Christian Church.
I release Country Christian Church and the above mentioned agencies from any liability or damages resulting from the release of this information. I waive any present or future claims of privacy resulting from this information for qualifications of volunteer work at Country Christian Church.