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Rayside Balfour Minor Hockey

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Association

P.O Box 4913 Chelmsford, Ontario, P0M 1LO

Phone 983 1500   Fax 983 1501

www.rbmha.on.ca

 

 

AUTHORIZATION FOR COLLECTION OF PERSONAL INFORMATION

 

 

I, _______________________________________, authorize the Rayside Balfour Minor Hockey Association to collect personal information appropriate to the position applied for by verifying the character references I have supplied.

 

 

I also understand that in order for my application to be considered, I must submit to a Criminal Record Check. (Police check)

 

 

I understand that the information obtained will be confidential but may be shared with relevant organizations in order to obtain an appropriate volunteer position.

 

 

 

Applicant's Signature _______________________ Date_________________

 

Witness _________________________________ Date_________________

 

 

 

 

 

 

 

 

 

 

2017-2018

 

SPONSORS

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RBMHA WOULD LIKE
TO THANK YOU
FOR YOUR SUPPORT