Clemson Little Theatre

The Miracle Worker

Background Check Consent & Authorization

Important: All adults working with youth participants in CLT productions must complete a background check. This information will be kept confidential and used only for the purpose of conducting a background check.

Note: Do NOT include your Social Security Number on this form for security reasons.

Authorization

I hereby authorize Clemson Little Theatre to conduct a comprehensive background check, including but not limited to:

  • Criminal history records
  • Sex offender registry check
  • Other public records as deemed necessary

I understand that:

  • The information provided will be kept confidential
  • A background check is required before I can work with youth participants
  • Certain findings may disqualify me from participating in CLT youth programs
  • I may request a copy of the background check report
  • This authorization is valid for the duration of my involvement with CLT

I certify that all information provided is true and accurate to the best of my knowledge. I understand that any false statements or omissions may result in denial or revocation of my volunteer/staff status with Clemson Little Theatre.

Signature *

By signing below, I authorize Clemson Little Theatre to conduct a background check.