Background Check Waiver Form

In accordance with the United Methodist Ministries of Mecosta County Abuse Prevention Policy, all staff and volunteers who work with children, youth, and vulnerable adults at the church must undergo a yearly background check. This is for the safety and security of all children, youth, adults with special needs, and volunteers.

By signing this waiver, you give the Director of Administrative Services of United Methodist Ministries of Mecosta County permission to perform a background check using the Michigan State Police ICHAT system.

A printed copy of this form and the resulting report will be kept confidential and secure for church records. You may request to see a copy of this file.

First and Middle Name

Last Name

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Date of Birth

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