Please read and make the MEMBER PROTECTION DECLARATION below: As a coach with the Club I sincerely declare: 1. I have never been charged with any criminal offence relating to child sexual abuse. 2. I am currently not the subject of any charge of a criminal offence relating to narcotics, violence or abuse including sexual abuse which has not yet been dealt with by the Courts. 3. I have not been found guilty by a Court of a criminal offence relating to narcotics, violence or abuse including sexual abuse. 4. No person has ever sought or obtained any intervention order, injunction or other restraining order against me alleging verbal or physical abuse (including sexual abuse). 5. I am not currently the subject of any sanction issued by a basketball association against me which prohibits me from holding a position of the type set out in clause 1 above. 6. No application submitted on my behalf has been rejected for, nor have I been suspended or dismissed from, a position in sport, volunteer organisation, business, educational or other Government or semi-government organisation where that rejection, suspension or dismissal relates to my conduct with persons aged under eighteen (18) years of age or to violence or drug use. 7. There are no other matters, which a reasonable person would consider relevant to the fitness of a person to be a coach of a team of players aged under eighteen or an administrator with frequent contact with persons aged under eighteen. 8. I will notify the President or CEO of the organisations appointing me to my position immediately upon becoming aware that any of the matters set out in clauses 2 to 6 above has changed for whatever reason.