Screening Disclosure Form and Privacy Statement (Lucan-Ilderton Baseball)

Print Screening Disclosure Form and Privacy Statement
PERSONAL INFORMATION
  1. Example: ###-###-####












DISCLOSURE INFORMATION
NOTE: FAILURE TO DISCLOSE A CONVICTION/SANCTION FOR WHICH A PARDON HAS NOT BEEN GRANTED MAY BE CONSIDERED AN INTENTIONAL OMISSION AND SUBJECT TO FAILURE OF SCREENING REQUIREMENTS AS REQUIRED BY THE ORGANIZATION'S SCREENING POLICY
CERTIFICATION
Human Validation
Printed from ildertonbaseball.com on Wednesday, June 29, 2022 at 10:08 PM