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Softball Insurance Background Screening Consent Form
To purchase softball team insurance, you must authorize and give consent for Top Gun Sports to obtain information about you as well as grant Top Gun Sports the authority to perform a background check on you.
Applicant's Legal Name:
Social Security Number:
Date of Birth:
Address:
City:
State:
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
ZIP Code:
Phone:
E-mail Address:
Team Name:
Age Group:
8U
8U MP
10U
12U
14U
16U
HSU
I authorize and give consent for the above named organization to obtain information regarding myself. This includes the following:
Local & National Criminal background records/information
All 50 State Sex Offender Registries
Full Address Trace
Social Security Verification
Yes
No
I authorize this information to be obtained either in writing or via telephone in connection with my application. Any person, firm or organization providing information or records in accordance with this authorization is released from any and all claims of liability for compliance. Such information will be held in confidence in accordance with the organization’s guidelines.
Yes
No
I am providing the above named Organization my consent for an initial background check as well as any subsequent background checks deemed necessary throughout the length of my volunteer assignment with this Organization.
Yes
No
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