Background Check Release

Criminal Background Check Release Form

I understand that a successful criminal background check is a condition of volunteering with the Buffalo Grove Park District and that while I may be allowed to work\volunteer after a criminal background search has been initiated, such duties will be conditional pending the return of the results of said search to the Buffalo Grove Park District, at which time my association with the District may be terminated without liability by the District in the event that the results of the search reveal a conviction or convictions for any one or more of the prohibited offenses.

I consent to the Buffalo Grove Park District obtaining my criminal conviction history from the Illinois State Police or the FBI.

I understand I will be provided a copy of the criminal background check if any felonies within the last seven years are reported, and my duty under the law to notify the Buffalo Grove Park District within 7 working days if the information is inaccurate or incomplete.

I hereby fully release and discharge the Buffalo Grove Park District, its commissioner, officers, agents and employees, from any and all claims for damages which may arise from participating in or as a result of the criminal background check, except for willful and wanton conduct.

I have read and fully understand this release form.
Last Name
Full Legal Last Name
First Name
Full Legal First Name
Middle Initial
Date of Birth
MM-DD-YYYY
Sex
Race
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Address
City
Zip
Home Phone #
Area-XXX-XXXX
Agreement
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I have read and fully understand this release form
Background Check
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Have you ever been convicted as, or found to be, a child sex offender?
Required Fields