I certify that the information contained in this application is correct to the best of my knowledge and understand that falsification of this application in any details is grounds for disqualification from further consideration, or for dismissal, in accordance with Southern Legacy of Life (SLL) policy. I agree to conform to the rules and regulations of the organization, and understand that my volunteer service can be terminated, with or without cause, and with or without notice, at any time at the option of either the organization or myself. I understand that this information may be disclosed to any party with legal and proper interest. I release the agency from any liability whatsoever for supplying such information. I grant permission for my image, picture and/or likeness to be used in SLL’s promotional and educational materials, unless I present a written objection to the Volunteer Coordinator. I hereby authorize Southern Legacy of Life to contact any company, person, or educational institution I listed as a reference on this application. I hereby release SLL and its agents and all persons, agencies, and entities providing information or reports about me from any and all liability arising out of the requests for or release of any of the above-mentioned information or reports.