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By checking the box above and submitting this form, I acknowledge I am over 18 years of age, and that I have truthfully and accurately completed this form including with respect to my identity and the purpose of my request. I acknowledge that the Diocese may, in its sole discretion, request further information from me in order to verify my identity and I agree to provide the Diocese with any further information requested prior to the release of any records. I consent to receive further communications pertaining to my request from the Diocese of Youngstown by email at the email address provided above. In addition, by checking the box below and as consideration for receiving any records in connection with my request, I agree, to the fullest extent allowed by law, to indemnify, defend and hold harmless the Bishop of the Roman Catholic Diocese of Youngstown and the Diocese of Youngstown, and their respective agents, representatives, and employees (the “Diocese”) from and against all claims including without limitation claims for misuse of information and/or invasion of privacy, damages, losses and expenses that in any way arise out of or relate to the records that I receive from the Diocese or the Diocese’s disclosure of such records to me.