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To Whom it May Concern:
I am an applicant for a volunteer position with the Austin Foundation. I understand that it is the program's responsibility to provide a safe environment in which youth can enjoy the program. In order to provide this safe environment, I understand that the Washington Child/Adult Abuse Information Act, Chapter 486, Laws of 1987, requires the Austin Foundation to investigate my personal history to evaluate my qualifications to hold the position for which I have applied. Therefore, I have authorized the Austin Foundation to gather pertinent information regarding my personal history, including information, which may be of a confidential or privileged nature.
I consent to your release of any and all public information public or private in three areas:
- Civil Adjudications: a specific court finding of sexual abuse or exploitation or physical abuse in a dependency action or in a domestic relations action.
- Conviction Record: criminal history record information relating to certain crime against persons.
- Disciplinary Board Final Decisions: Dept. of Licensing findings of physical/sexual abuse or exploitations of a child.
By checking this box, I hereby agree to release you and those who supplied you with information of any kind, the Austin Foundation and any Austin Foundation programs from any liability for any damage which may result from furnishing requested information.
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