12 01 2005 Rec Tech Agenda
ORO-MEDONTE RECREATION
TECHNICAL SUPPORT GROUP
AGENDA
7:00 p.m.
Thursday December 1, 2005 @
st
Oro-Medonte Administration Centre
1. Adoption of Agenda.
2. Disclosure of Pecuniary Interest and General Nature Thereof – In
Accordance with the Act.
3. Adoption of Minutes from the previous Recreation Technical Support
Group Meeting.
(a) Thursday October 6, 2005
th
4. Deputations:
Nil.
5. Unfinished Business:
(a) Discussions and comments with respect to the Parks and Recreation
Accident/Incident Report.
6. Correspondence:
Nil.
7. Co-ordinator’s Monthly Report:
(a) Update re: 2005 Fall Recreation Brochure and “draft” 2006 Winter Fall
Recreation Brochure.
(b) Sweet Water Park
8. Other Business (Information or request for future information):
9. Questions:
10. Adjournment:
th
Thursday January 5, 2005 @ 7:00pm
Next Meeting:
Ontario
Provincial
Police
Appendix C H
CONSENT TO DISCLOSURE OF PERSONAL INFORMATION
Volunteer/Applicant Screening Process
I:l Foster Parenting/Adoption
I:l Volunteer Work
I:l Empioyment
APPLICANT INFORMATION
Surname: Given Names:
-
Maiden Name or Other Names used (if applicable): Place of Birth:
D.O.B. MM Day Sex Area Code Telephone (Res.) Driver's Licence Number
Yr
Address: Number Street Apt/Unit Town/Municipality Postal Code
PREVIOUS ADDRESS FOR THE LAST FIVE YEARS'
Address: Number Street Apt/Unit Town/Municipality Postal Code
Address: Number Street Apt/Unit Town/Municipality Postal Code
Address: Number Street . Apt/Unit TownIMunicipality Postal Code
tlease Read Carefully:
ereby consent to full disclosure, by the Ontario ProvincJal Police (OPP) to the person(s) listed below, of all pollce record information. This consent
eludes the release of records of criminal convictions for which a pardon has not been granted, records of discharges which have not been granted,
records of discharges which have not been removed from the CPIC system in accordance with the Criminal Records Act, or any convictions registered,
charges pending or any other judicial order issued under an Act of Parliament or an Act of the Legislature. This consent also includes and authorizes the
release of information available form the files of the OPP or any other pollee agency, including occurrence information, which the OPP deems necessary
to fulfil the requirements of the volunteer/applicant screening process. This consent is given pursuant to s. 42(b) of the Freedom of Information and
Protection of Privacy Act.
Name; Title:
Name of Organization:
The Criminal Records Act, provides for additional information to be provided to a person or organisation responsible for the well being of one or more
children or vulnerable persons. I am an applicant for a paid or volunteer position with such a person or organisation, as defined by the Criminal Records
Act. as defined below:
Description of the paid or volunteer position
Name of the person or organization Title
Details regarding the child(ren) or vulnerable person(s)
Therefore, pursuant to a request by the above person or organisation, 1 hereby consent to a search of the automated criminal records retrieval system
maintained by the Royal Canadian Mounted Police to determine if I have been convicted of, and been granted a pardon for, any of the offences listed in
the schedule to the Criminal Records Act. I understand that pursuant to this consent, If I am determined to be the person named In a criminal record as
_scribed above, that record may be disclosed to the Ontario Provincial Police (OPP) and the OPP will then disclose that information to me and to the
rson or organisation referred to above.
RELEASE AND DISCHARGE
I h~reby release and forever discharge Her Majesty the Queen In right of Ontario, the Commissioner of the Ontario Provincial Police and ail
rri~l11bers and employees of the OPP from any and ali actions, claims and demands for damages, loss or Injury howsoever arising which may
hereafter be sustained by myself as a result of the disclosure of Information by the OPP to the above named organisation.
Signature of Applicant
Date
Signature - Organization Witness
Identification verified by
Confidential
This record and the information contained therein, is being provided in confidence and shall not be disclosed to any person with the exception of the
person(s) named above wilhoullhe express wrltlen consenl of the Commissioner of the OPP.
I:l Fails to reveal any record relating to the above subject.
I:l Based on the Information provided, a criminal record may relate to the above person, this can only be
confirmed by submitting fingerprints.
I:l Based on the information provided, a police record may relate to the above person.
LE220 (Rev. 01/2002)
P: fbatchllemplales/Crlmlnal Reference Check legal combIned
See reverse -+
,,,
Request to Check Pardoned Sexual Offender Database
.
Date:
Name & Address of organization:
Attention: O.P.P.
Re: Police Record Check
As the authorized representative of a person or organization that is responsible for the well being of
one or more children or vulnerable persons as defined in section 6.3(1) of the Criminal Records Act, I
hereby request that the Ontario Provincial Police
conduct a search
do not conduct a search
pursuant to s. 6.3 of the Act with respect to the following individual
.
Name of Organization:
Signature:
Date:
.