Applicant Statement:
I certify that my answers are true and complete to the best of my knowledge. I authorize you to make such investigations and inquiries into my background as may be necessary to determine my fitness for working with and around children. I hereby release employers, schools or individuals from all liability when responding to inquiries in connection with my application.

Image Release:
In consideration of the opportunity to participate in CHM programs, I hereby agree to your recording of my name, appearance, image, voice and participation in the program for the use in any promotional and/or marketing or other CHM related materials.