I understand that I have made an application for a volunteer opportunity with the Agency and it is not a commitment or promise of a volunteer opportunity by the Agency. I understand that it is in the Agency's discretion whether to accept me as a mentor and the Agency has no obligation to provide me with a reason for its decision to accept or reject me as a mentor.
I represent and warrant to the Agency that all information that I have or will provide to the Agency during the selection process, including information on this application and in interviews with Agency, is true, correct and complete to the best of my knowledge. I further agree that I have and will answer all questions posed by the Agency to the best of my knowledge and that I have not and will not withhold any information that would unfavorably affect my application for a volunteer position. I understand that any misrepresentations or omissions by me may be cause for my immediate rejection as an applicant for a volunteer position with the Agency or my termination as a volunteer.
I hereby authorize the Agency to request and obtain any and all records, documents and information about me from employers, agencies and references included on my application necessary for the Agency to evaluate my suitability as a mentor. I understand that the Agency will check some or all of the following: my records on the national sex offender registry, the Vermont child abuse and neglect registry, the Vermont criminal conviction search, FBI Fingerprint-based Background Check, and Vermont Motor Vehicles Driver Record Check. I hereby consent to the release of such records, documents, and information to Agency and to the Agency’s designated representatives. I release and agree to defend and hold harmless from liability any person or organization that provides information.
I agree and acknowledge that this information may be disclosed by Agency officials to persons involved in the implementation of Agency activities and programs. I hereby release and agree to defend and indemnify the Agency, its directors, officers, partners, employees, affiliates, agents, successors, and its designated representative from any and all claims that may result from the use, release and disclosure of such information.
I HAVE CAREFULLY REVIEWED THIS "INFORMATION RELEASE AND COVENANT NOT TO SUE" AND I HEREBY CONFIRM MY UNDERSTANDING OF ITS CONTENTS AND AGREE TO BE BOUND BY ITS TERMS AS A CONDITION OF MY PARTICIPATION IN THE ABOVE ACTIVITY.
I am 18 years of age or older.