Umpire Application and Consent for Background Check -Spring 2022

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Granbury Athletic Association Spring 2022 Umpire Registration / Background Check Form
This information you put in this form will be used to send you a link from JDP for a full background check. Please be on the lookout for that email.
*Please note, this application is only for those who wish to be an Umpire with GAA.  If you have any questions about the requirements / responsibilities of being an umpire, please contact us at info@granburyathletic.com BEFORE completing this form.
Applicant Information
*First Name
*Last Name
Maiden Name (if applicable)
Other Name(s)
you have used as an adult
*Street Address
*City
*State
*Zip Code
*Email
*Daytime Phone
Evening Phone
Mobile Phone
*Birthdate
*Drivers License Number
*Drivers License State
Division
*Select the Division you desire to Umpire
Do you wish to be a Plate or Field Umpire?
*Please select your desired Role
Experience
*Have you been an umpire before?
Please provide a brief description of your umpiring experience:
Explanation 1
Arrest and Conviction Record
Have you ever been convicted of a felony involving harm to a child or minor in any way?
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Have you ever been convicted of a felony or misdemeanor involving improper conduct with, towards, or around a minor?
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Agreement/ Authorization
Do you agree to abide by all of the following:
-Abide by all the rules of Granbury Athletic Association  ("GAA")
-To conduct myself in both speech and action in a manner that will be a positive influence on the players and will be beneficial to GAA and the community
-To do my utmost to teach sportmanship, leadership, fair play and citizenship
- If for any reason, my behaviors are deemed by the Granbury Athletic Association Board to be "not in the best interest" of the league, I will be required to end my status with the league.
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Background Check Authorization
I hereby give my permission for Granbury Athletic Association to obtain information related to my background, including any criminal history record through Granbury Athletic Association's criminal background company of choice.  The criminal history record, as received from the reporting agencies, may include arrest and conviction data as well, as plea bargains and deferred adjudications.  I understand that this information will be used in part to determine my eligibility for an employee or volunteer position with Granbury Athletic Association.  I also understand that as long as I remain an employee or volunteer with Granbury Athletic Association that the criminal history records check may be repeated at any time.  In the event that I dispute the record as received, I understand that I will have an opportunity to review the criminal history information with Granbury Athletic Association and have an opportunity to clarify the information.
I, the undersigned, do, for myself, my heirs, executors and administrators, hereby remise, release, and forever discharge and agree to indemnify and hold harmless Granbury Athletic Association, each of their officers, Board members, causes of actions, suits, liabilities, costs, debts, and sums of money, claims and demands whatsoever, and any and all related attorneys' fees, court costs, and other expenses resulting from the investigation of my background in connection with my application to become an employee or volunteer with Granbury Athletic Association.
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By agreeing below, I consent that all the information provided in this form is true and correct, and that this shall serve as my electronic signature.
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