I hereby authorize the First United Methodist Church of High Springs, Florida to request any local, state or federal law enforcement department or agency to release information regarding any record of any investigations, charges or convictions contained in its files, or in any criminal file maintained on me, whether said file is a local, state, or national file, and including but not limited to accusations and convictions for crimes committed, against minors, to the fullest extent permitted by local, state and federal law. I release any and all law enforcement departments, agencies, and their employees from all liability that may result from any such disclosure made in response to this request.
You are authorized to rely upon a photocopy or fax copy of this document.
I understand that typing my name in this box constitutes a legal signature confirming that all information is complete and accurate.
