Name(Required) First Last A conflict of interest, or an appearance of a conflict, can arise whenever a transaction, or an action, of High Sierra Discipleship Camp conflicts with the personal interests, financial or otherwise, of that of a board member, or an immediate family member of a board member, or that the board member’s employer (collectively “your personal interests”). Please describe below any relationships, transactions, or positions you hold (volunteer or otherwise), or circumstances that you believe could create a conflict of interest, now or in the future, between High Sierra Discipleship Camp and your personal interests, financial or otherwise: Do you have any actual, or perceived, conflicts of interest to report?(Required)I have no conflicts to report.I have one or more conflicts to report:Briefly describe your actual, or perceived, conflict of interest:(Required)Consent(Required) I have reviewed High Sierra Discipleship Camp’s conflict of interests policy and I understand that it is my obligation to disclose a conflict of interests, or appearance of a conflict, to the chair of the board when a conflict, or appearance of a conflict, arises, and that for transactions in which I have a conflict, I will abstain from any vote on the matter involving the conflict. Further, I understand that HSDC is charitable and in order to maintain its federal tax exemption it must engage primarily in activities which accomplish one or more of its tax – exempt purposes.Signature(Required)