Criminal Offence Declaration Name* First Last Email* Team*-- House League Teams --FUNdamentalU9 (Formerly Novice) House LeagueU9 (Formerly Novice) CompetitiveU11 (Formerly Atom) House LeagueU11 (Formerly Atom) CompetitiveU13 (Formerly Peewee) House LeagueU13 (Formerly Peewee) CompetitiveU15 (Formerly Bantam) House LeagueU15 (Formerly Bantam) CompetitiveU18 (Formerly Midget) House LeagueU18 (Formerly Midget) CompetitiveU22Role*Head coachAssistant coachOn-ice helperOff-ice helperTrainerManagerTreasurerDen momFailure to execute this process will be in violation of the OWHA Screening Policy, this will mean that the individual will be considered to be not in good standing and may be prohibited from volunteering.Since the last police record check provided to the Head of Certifications with the Nepean Girls Hockey Association, regarding any convictions or outstanding charges for offences under the Criminal Code of Canada, and including the date of this declaration, for which a pardon has not been issued or granted under the Criminal Records Act (Canada) :*Please selectYes, I do have convictions or outstanding charges for offences.No, I do not have any convictions or outstanding charges for offences.I acknowledge that by typing my full name that I am adding my signature in agreement to the information provided in the Criminal Offence Declaration form.*