‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ 
Fair Oaks Recreation & Park District

CERTIFICATION OF BACKGROUND CHECKS


Contractor


___________________("Contractor" listed above) acknowledges that pursuant to California Public Resources Code §5164 that no person (e.g., employee of Contractor, volunteer, or independent contractor or subcontractor hired by Contractor) may be in a position having supervisory or disciplinary authority over a minor (any person under the age of eighteen) if that person has been convicted of any of various specified offenses¹. This prohibition applies to Contractor, Contractor’s employees or volunteers, and any contractors or subcontractors used by Contractor, or the employees or volunteers of those contractors or subcontractors.
Contractor certifies that Contractor has required each person who may be in a position of having supervisory or disciplinary authority over a minor to have had fingerprints taken and submitted to the California Department of Justice for verification, and that such person has not been convicted of the disqualifying offenses, and that Contractor will be notified of any future disqualifying offenses. All such persons are identified below:


Name of Employee(s) | Position | Date of Background Check *


Electronic signature

Contractor is required to provide updated information to the District as these persons change. Contractor further acknowledges that by this Certification of Background Checks, Fair Oaks Recreation & Park District will not independently verify the information provided by Contractor; so therefore the Contractor shall indemnify, defend and hold harmless the District, its elected and appointed officials, and its employees from and against any and all claims, loss, liability and damages resulting from injury or death to any person arising out of or in connection with the misrepresentation or inaccuracy of any information provided herein.

Signature pad
Signature pad

¹ Violations or attempted violations of §§ 220, 261.5,262, 273a, 273d, or 273.5 of the California Penal Code, or any sex offense listed in § 290 of the Penal Code, except for the offense specified in subdivision (d) of § 243.4 of the Penal Code, within ten (10) years of the date of such person seeking to be employed or serve as a volunteer of Contractor.


A required field has not been filled.

Please accept all conditions.

Connect to fill this form

Please type in your email or mobile number. We will send you a connection code.

Waitlist

  

Leave us your coordinates. We will contact you when a spot frees up.

Please wait...

Membership

Your membership is tied to your email address. If you are using the wrong email, your membership will not be detected. You can try disconnecting and connecting using another email address.

If you need further assistance, please write to info@activitymessenger.com. Please include a screen capture if possible.

  Facebook   Twitter   Instagram   Youtube  

© 2026 Fair Oaks Recreation & Park District

4150 Temescal Street, Fair Oaks, CA, 95628, US  916-966-1036

www.forpd.org  registration@forpd.org

Activity Messenger is Emails, SMS, Forms & Waivers built for Sports & Leisure.