I Declare that:
1. I am aware of my obligations under the Member Protection Policy issued by the Coolbinia Bombers JFC. (Policy available for viewing at www.bombersjfc.asn.au )
2. I do not have any criminal charges pending before the courts.
3. I do not have any criminal convictions or findings of guilt for sexual offences, offences related to children or acts of violence.
4. I have not had any disciplinary proceedings bought against me by an employer, sporting organisation or similar body involving child abuse, sexual misconduct or harassment, or other form of harassment or acts of violence.
5. To my knowledge there is no matter that the Coolbinia Bombers JFC may consider constituting a risk to its members, employees, volunteers, athletes or reputation by engaging me in a paid or voluntary position.
6. I will notify the President of the Club immediately upon becoming aware that any matters set out in numbers 2 to 5 above have changed.