Criminal Offence Declaration (Burlington City Rep Hockey Club)

Criminal Offence Declaration

Personal Info

Last Name^*

Required

First Name^*

Required

Date of Birth^*

Required

Email Address^*

Required

Example: [email protected]. Your submission will be sent to this address.

Declaration

Please choose one of the following

I have no convictions for offenses under the Criminal Code of Canada as outlined in the OMHA Police Record Check Policy, up to and including the date of this declaration for which a pardon has not been issued or granted under the Criminal Records Act (Canada).
I have the following convictions for offenses under the Criminal Code of Canada as outlined in the OMHA police Record Checks Policy, for which a pardon under the Criminal Records Act (Canada) has not been used or granted

Conviction(s):

I hereby declare the above statements to be true

Yes^*

Criminal Offence Declaration (Burlington City Rep Hockey Club)

OMHA Digital Network

Personal Info

Declaration

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