5
CERTIFICATIONS
I understand that this application is only valid for the position applied for at present and that the YMCA is no
obligated to retain or consider this application for future openings.
Initial
I authorize investigation of all statements contained in this application. I understand that falsification,
misrepresentation of omission of facts called for will result in immediate termination from employment or removal of
my application from consideration. I authorize the YMCA to secure information about my experience with former
employers, educational institutions and agencies, and for those parties to provide information concerning my
experience releasing all parties from any liability arising there from.
Initial
If employed by the YMCA, I will abide by Association policies and rules. I understand that I will be required to
possess a current and valid driver’s license with a clean driving record in accordance with Association policy if my
position requires me to drive in the course of my work.
Initial
I agree to submit to legally permissible drug and/or alcohol testing, child abuse clearance, and police clearance
checks at pre-employment and beyond that, upon request by the YMCA. I recognize that the result of these tests
may be used to determine my employment or continued employment. I understand and expressly agree that if
employed by the YMCA, storage areas provided for me (locker, desk, etc.) are open to investigation by the YMCA
without prior notice to me.
Initial
If I am employed by the YMCA, I understand that it is on an “at-will” basis and that my employment can be
terminated, with or without cause, and with or without notice, at any time at the option of the YMCA or myself. I
understand that, other than the CEO of the YMCA, no manager, supervisor or representative of the YMCA has
authority to enter into any agreement for employment for any specific period of time, or to take any agreement
contrary to the foregoing or contrary to Association policy. Only the CEO of the YMCA has the authority to make any
agreement contrary to the foregoing and then only in writing. I further expressly agree that , with respect to the “at
-will” employment relationship between the YMCA and myself.
Initial
My
signature below certifies that I have read and understand the foregoing and to the best of my
knowledge and belief, the information on this form is true and correct.
My
signature below also certifies that I agree to be bound by the terms and conditions stated in this
application. This application contains all the understandings and agreements between me and the YMCA
concerning the nature of my employment, if any, by the YMCA and supersedes al prior and/or
contemporaneous practices, oral or written agreements, understandings, statements, representations
and promises, express or implied, between me and the YMCA. I understand and agree that, except as
noted above, no person who is either an agent or employee of the YMCA may modify, delete, vary or
contradict, whether orally or in writing , the terms and conditions set forth herein.
Applicant Signature Date
Parent or Guardian’s Signature Date
(required if under 18)
