Have you ever been the subject of an investigation, disciplined, sanctioned or dismissed from a coaching, teaching or volunteer position, by a sport governing body or its member club, or by an independent body (e.g, private tribunal, government agency, school board etc.)? *
Have you ever been refused admission/membership or renewal of membership to any professional organization or sporting organization? *
PRIVACY INFORMATION
By completing and submitting this Screening Disclosure Form, I consent and authorize NU Sport Federation to collect, use and disclose my personal information, including all information provided on the Screening Disclosure Form as well as my Enhanced Police Information Check and/or Vulnerable Sector Check (when permitted by law) for the purposes of screening, implementation of the Screening Policy, administering membership services, and communicating with Nunavut Territorial Sport Organizations.
NU Sport Federation and other Territorial Sport Organizations do not distribute personal information for commercial purposes.
CERTIFICATION
I hereby certify that the information contained in this Screening Disclosure Form is accurate, correct, truthful and complete. I further certify that I will immediately inform NU Sport Federation of any changes in circumstances that would alter my original responses to this Screening Disclosure Form. Failure to do so may result in the withdrawal of volunteer responsibilities or other privileges and/or disciplinary action.
By signing this document below, I agree to adhere to the policies and procedures of NU Sport Federation and its member TSO’s (as applicable), including but not limited to the Code of Conduct and Ethics, Conflict of Interest Policy, Privacy Policy, and Screening Policy.
I have read and agree to the above. *
I recognize that I must pass certain screening requirements depending on the position sought, as outlined in the Screening Policy, and that the Screening Committee will determine my eligibility to volunteer or work in the position. *
CRIMINAL RECORD CHECK ACKNOWLEDGEMENT
I acknowledge that I have completed a Police Record check with a Vulnerable Sector Screening or an Enhanced Police Information Check (E-PIC) through mybackcheck.com in the past 90 days. If you need to complete a Police Record check with a Vulnerable Sector Screening or an Enhanced Police Information Check (E-PIC). Click Here to request the CRC/EPIC Online Form. *
In consideration of the acceptance of the Registrant’s registration with NU SPORT, I agree:
1. I have read this Agreement in its entirety, accept its terms and conditions, and that I have executed this Agreement voluntarily.
2. To abide by the policies, rules and regulations of NU Sport and its Members, as amended from time to time.
3. This Agreement shall be governed by and construed in accordance with the laws of the territory of Nunavut and the federal laws of Canada applicable therein. The courts of the territory of Nunavut shall have exclusive jurisdiction to settle any dispute arising out of or in connection with this Agreement (including any question regarding its existence, validity, breach or termination). I further agree that if any portion of this Agreement is found to be void or unenforceable, the remaining document shall remain in full force and effect. This Agreement (i) constitutes the entire agreement between the parties hereto and supersedes any prior agreement with respect to the subject matter hereof whether oral or written and (ii) is not intended to confer any rights or remedies hereunder upon any person not a party to this Agreement. No person will be deemed to be a third-party beneficiary of this Agreement
4. That this Agreement is to be binding upon myself, my heirs, spouse, children, parents, guardians, next of kin, executors, administrators and legal or personal representatives.
J’ai lu et accepte les conditions ci-dessus *
PARENT/GUARDIAN CONSENT - COMMUNITY COACH TRAVEL AND SUPERVISION
I, the parent/legal guardian of the participant named in this registration, understand and acknowledge that my child may participate in NU Sport Federation recognized (sanctioned) events, competitions, tournaments, training camps, clinics, and other sport-related activities that require travel outside of their home community.
I understand and agree that:
For each event requiring travel, my child may travel with and be under the supervision of an approved Community Coach, Team Manager, or other designated adult team representative.
NU Sport Federation requires designated Community Coaches and team representatives responsible for travelling with youth participants to complete the applicable screening requirements and required Sport Integrity/Safe Sport training established by NU Sport Federation.
The Community Coach or designated team representative may be responsible for supervising my child during travel, including at airports, on flights, during ground transportation, at accommodations, at competition venues, and during other approved team activities associated with the event.
I understand that the Community Coach or designated team representative is responsible for the general supervision and well-being of the team; however, reasonable supervision does not mean that participants will be under direct, continuous observation at all times.
I understand that different events may have different coaches, managers, or designated team representatives and that the individual responsible for travelling with and supervising my child may change from one event to another.
I understand that my child is expected to follow all NU Sport Federation policies, Codes of Conduct, team rules, travel requirements, curfews, and reasonable instructions provided by the Community Coach, Team Manager, or designated team representative.
By providing my consent, I confirm that I understand these travel and supervision arrangements and authorize my child to travel to and participate in NU Sport Federation sanctioned events under the supervision of an approved and appropriately screened Community Coach, Team Manager, or designated team representative.
I acknowledge that this consent applies to NU Sport Federation sanctioned events for which my child is registered or selected, subject to any additional event-specific consent or travel requirements.