CRIMINAL RECORD CHECK FORM


 

 

WESTLOCK SOCCER ASSOCIATION

 

Coaches, Assistants and Board Members - Police Information Check

 

Westlock Soccer Association requests that Coaches, Assistants, and Board Members have their Police Information Check from the Westlock Detachment (R.C.M.P.) located at 10807-104 Avenue, Westlock AB T7P 1B3 . The WSA Board will request result of the Security Check prior to the seasons start. You must go in person and have two pieces of id, including one photo identification with you. This is done at no cost to the volunteer, but you must live in the Westlock RCMP Detachment area.

 

Name_____________________________________________________

(Please Print Name in Full)

 

Coach Assistant Board Member
(Please Circle Your Role)

 

Address______________________________________________________

 

Phone #______________________________________________________

 

D.O.B________________________________________________________

 

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