RELEASE AND WAIVER

I hereby authorize V & G Event Services to now, or any time while I am employed conduct an independent investigation of credit, character, general reputation, personal characteristics or mode of living from both public and private organizations. I understand that I am entitled to request, in writing, the nature and scope of the investigative report.

This authorization for release of information includes, but is not limited to, matters of opinion relating to my character, ability, reputation and past conduct. I authorize and request all persons, schools, businesses, corporations, credit bureaus, courts, law enforcement and other government agencies to release such information without restriction or qualification.

I agree to release V & G Event Services and/or its agents and affiliates form any and all liability, claims, or lawsuits in regards to information obtained from any or all of the sources contacted in regards to the investigative report. I further agree that failure to reveal any employment I may have had within the last ten (10) years, and/or giving false or misleading information on any documents associated with any employment may result in refusal of my employment.

Please list any other names you have used during the past ten (10) years, and when:

Name used Date used
__________________________________ ____________
__________________________________ ____________

Social Security # _____ - ____ - _________ Drivers License #: _____________________

[ ] I understand that I may be required to submit to drug testing.

Name (Please print). __________________ ___ ____________________
FIRST MI LAST

Signature: ________________________________

Date: _______________

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