I certify that all the statements made in this application are true and correct and that I have not
misrepresented or withheld any information. I understand that the falsification of this information may result in
immediate dismissal. I hereby authorize all references listed on my volunteer application to give CCACC any
and all information pertinent to my position as a volunteer that may be needed as far as behaviors, personal
or otherwise, and release all parties from any claims, causes of action, or liability from damages that may or
could result from furnishing such information to the company.