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I hereby give my permission for Reconciliation Outreach Ministries to obtain information relating to my criminal history record 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 adjudications. I understand that this information will be used, in part, to determine my eligibility for a volunteer position with this organization. I also understand that as long as I remain a volunteer here, the criminal history records check may be repeated at any time. I understand that I will have an opportunity to review the criminal history and a procedure is available for clarification if I dispute the record as received.

I, the undersigned, do for myself, my heirs, executors, and administrators, hereby release and forever discharge and agree to indemnify Reconciliation Outreach Ministries, The Volunteer Center of Dallas County and each of their officers, directors, 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, and any and all related attorneys’ fees, court costs, and other expenses resulting from the investigation of my background in connection with my application to become a volunteer.

I hereby irrevocably grant to Reconciliation Outreach Ministries the absolute right and permission to copyright and/or publish or use photographic portraits or pictures of me, or in which I may be included in whole or in part, or composite or distorted in character or in form, in conjunction with may name or a fictitious name, or reproductions thereof in color in otherwise, made through any media, for art, advertising, or any other lawful purpose whatsoever. I also grant Reconciliation Outreach Ministries the same right and permission to use any statement or testimonials made by me.