MBI Background Check

Prospective Employer:   Mesquite Baseball Inc.
Branch Code:  Parks & Recreation/Bldg Service Dept (Parks)

NOTICE TO VOLUNTEER/COACH APPLICANTS

Your prospective employer has contracted with DCS, a Texas-licensed, Private Investigations Agency, to verify certain informaiton contained in your application to volunteer.  The information requested below is necessary to complete this task.  The information is not a part of the application for employment and will be used for the sole purpose of verification of information and/or statements made by you.

Please complete al information requested. 

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Residential History:   List all residential addresses over the last seven years:
(If different from current address)
Include dates when you lived at each address
 
 
 
 
It is possible that your volunteer services may be determined in whole or part by your prospective employer using data from a report supplied by DCS.  Pursuant to section 609 of the Fair Credit Reporting Act, you may be entitled to a copy of this report.
 
Applicant Consent:
 
The information contained in this application pertains to me, and is correct to the best of my knowledge. I hereby authorize Mesquite Baseball Inc. and its designated agents and representatives to conduct a comprehensive review of my background causing a consumer report and/or an investigative consumer report to be generated for employment and/or volunteer purposes. I understand that the scope of the consumer report/ investigative consumer report may include, but is not limited to the following areas: verification of drivers license number; current and previous residences; and criminal history records from any criminal justice agency in any or all federal, state, county jurisdictions; driving records, birth records, and any other public records.

I further authorize any individual, company, firm, corporation, or public agency to divulge any and all information, verbal or written, pertaining to me, to Mesquite Baseball Inc. or its agents. I further authorize the complete release of any records or data pertaining to me which the individual, company, firm, corporation, or public agency may have, to include information or data received from other sources.

Mesquite Baseball Inc. and its designated agents and representatives shall maintain all information received from this authorization in a confidential manner in order to protect the applicants personal information, including, but not limited to, addresses, drivers license numbers, and dates of birth.

I release and hold harmless from all liability any individual or entity requesting or supplying information with respect to my application for employment.

Signature *
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Volunteer Release and Waiver of Liability

This Release and Waiver of Liability (the "release") releases Mesquite Baseball, Inc., a nonprofit corporation organized and existing under the law of the State of Texas and each of its directors, officers, employees, and agents. The Volunteer desires to provide volunteer services for Mesquite Baseball, Inc. and engage in activities related to serving as a volunteer baseball advisor.

Volunteer understands that the scope of Volunteer’s relationship with Mesquite Baseball, Inc. is limited to a volunteer position and that no compensation is expected in return for services provided by Volunteer; that Mesquite Baseball, Inc. will not provide any benefits traditionally associated with employment to Volunteer; and that Volunteer is responsible for his/her own insurance coverage in the event of personal injury or illness as a result of Volunteer’s services to Mesquite Baseball, Inc.

  

1. Waiver and Release: I, the Volunteer, release and forever discharge and hold harmless Mesquite Baseball, Inc. and its successors and assigns from any and all liability, claims, and demands of whatever kind or nature, either in law or in equity, which arise or may hereafter arise from the services I provide to Mesquite Baseball, Inc.. I understand and acknowledge that this Release discharges Mesquite Baseball, Inc. from any liability or claim that I may have against Mesquite Baseball, Inc. with respect to bodily injury, personal Injury, illness, death, or property damage that may result from the services I provide to Mesquite Baseball, Inc. or occurring while I am providing volunteer services.

2. Insurance: Further, I understand that Mesquite Baseball, Inc. does not assume any responsibility for or obligation to provide me with financial or other assistance, including but not limited to medical, health or disability benefits or insurance of any nature in the event of my injury, illness, death or damage to my property. I expressly waive any such claim for compensation or liability on the part of Mesquite Baseball, Inc. beyond what may be offered freely by Mesquite Baseball, Inc. in the event of such injury or medical expenses incurred by me.

3. Medical Treatment: I hereby release and forever discharge Mesquite Baseball, Inc. from any claim whatsoever which arises or may hereafter arise on account of any first-aid treatment or other medical services rendered in connection with an emergency during my tenure as a volunteer with Mesquite Baseball, Inc.

4. Assumption of Risk: I understand that the services I provide Mesquite Baseball, Inc. may include activities that may be hazardous to me including, but not limited to bodily injury and property damage involving inherently dangerous activities. As a volunteer, I hereby expressly assume the risk of injury or harm from these activities and release Mesquite Baseball, Inc. from all liability for injury, illness, death or property damage resulting from the services I provide as a volunteer or occurring while I am providing services.

5. Photographic Release: I grant and convey to Mesquite Baseball, Inc. all right, title and interests in any and all photographs, images, video, or audio recordings of me or my likeness or voice made by Mesquite Baseball, Inc. in connection with my providing volunteer services to Mesquite Baseball, Inc.

6. Other: As a volunteer, I expressly agree that this Release is intended to be as broad and inclusive as permitted by the laws of the State of Texas and that this Release shall be governed by and interpreted in accordance with the laws of the State of Texas. I agree that in the event that any clause or provision of this Release is deemed invalid, the enforceability of the remaining provisions of this Release shall not be affected.

By signing below, I express my understanding and intent to enter into this Release and Wavier of Liability willingly and voluntarily.

I have read, and I agree with each of the above statements. *
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Youth Coaches Code of Conduct

I truly understand that youth sports are intended for the children and not for adults.
 
I will place the well being of my players ahead of my personal desire to win.
 
I will provide a safe and fun environment for all of my players.
 
I will treat each player with respect and not use abusive language towards my players, parents, spectators and/or league officials.
 
I will be knowledgeable of the rules of the sport that I coach and will teach those rules to all of my players.
 
I will demonstrate good sportsmanship and fair play towards my players and opponents.
 
I acknowledge that I am STRONGLY ENCOURAGED to require any player who plays catcher (all leagues except T-Ball) to wear a protective cup or other equivalent protective equipment.
 
I agree that all youth sports coaches must have a criminal background check conducted on an annual basis, and it will be kept on file with my league officials.
 
I agree that if I violate any of the above codes I may be disciplined and/or relieved of my duties by the league as a youth sports coach and/or league official.
 
I affirm that I have never been convicted (including crimes where a plea of “no contest” was entered) of a crime of child abuse, sexual assault, child neglect, murder, voluntary manslaughter, felony assault, arson, robbery, burglary, indecent exposure, public lewdness, terrorist threat, any offense against a minor, kidnapping, or felony violation of the Controlled Substance Act.
 
I affirm that I have never been twice convicted, in any combination, of Misdemeanor Assault or any level violation of the Controlled Substance Act.
 
I affirm that I have not been twice convicted during the past seven years of any intoxication offense.
 
I affirm that I have never been adjudged liable for civil penalties or damages involving sexual or physical abuse of children.
 
I affirm that I have never been subject to any court order involving any sexual abuse or physical abuse of a minor, including but not limited to a domestic order for protection.
I have read, and I agree with each of the above statements. *
Signature *
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