MYHA Background Check and SafeSport Verification Form

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(UPDATED 9/10/2019) Please have your USA Hockey registration, MN Hockey Background Screen FROM THIS YEAR, AND SafeSport Training completed prior to completing form. All components must be completed prior to fulfilling your dibs hours for try-outs and fall camp locker room attendants and team managers. If you have any questions or issues completing this form please contact myhadibs@gmail.com. Thank you for your contribution to MYHA hockey!

Email *

Full name *

USA Hockey Number *

I completed my MN Hockey background screen THIS season (2019-2020). You must forward a copy of the results to myhadibs@gmail.com to verify eligibility. *

YES

I completed SafeSport Training. You must forward the copy of completion certificate to myhadibs@gmail.com to verify completion for eligibility. *

YES

A copy of your responses will be emailed to the address you provided.

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