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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: .