Annual Offense Declaration

Annual Offence Declaration Form - Feb 2026

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Please read and complete this Annual Declaration Form to confirm your compliance with the policies and responsibilities outlined by Big Sisters of BC Lower Mainland. This form includes declarations regarding any criminal convictions or investigations, adherence to our Confidentiality Policy, and your legal Duty to Report as required by the Child, Family and Community Service Act (CFCSA) of British Columbia. By submitting this form, you are helping us maintain a safe and professional environment for the individuals we serve and ensuring your eligibility to continue in your role.

1. OFFENCE DECLARATION:

Offence Declaration - I DECLARE, since the last Criminal Records Check provided to Big Sisters of BC Lower Mainland, or since the last Annual Offence Declaration Form submitted to Big Sisters of BC Lower Mainland, that I and my live-in partner (please check all boxes that apply):

Declaration Statements

have no convictions under the Criminal Code of Canada, up to and including the date of this declaration for which a pardon has not been issued or granted under the Criminal Records Act (Canada).

have no pardons related to sexually based offences up to and including the date of this declaration under the Criminal Records Act (Canada).

have no charges pending under the Criminal Code of Canada up to and including the date of this declaration.

have not been the subject of any criminal investigation or allegation, any child welfare investigation or allegation, nor have I had any charges brought against me or my live-in partner, even if the charges are pending.

My driver’s license has not been suspended, restricted or revoked for any reason.

Please check the appropriate line:

Summary Confirmation*

There have been no occurrences as described above since my last Criminal Record Check or submission of an Annual Offence Declaration Form.

All reportable matters as described above were discussed with Agency Staff and/or the Executive Director at the time of the occurrence(s).

2. CONFIDENTIALITY:

3. DUTY TO REPORT – CHILD SAFETY:

DECLARATION:

By checking the boxes above, signing, and/or submitting this form, you consent to the collection and use of your personal information by Big Sisters of BC Lower Mainland and Big Brothers Big Sisters of Canada (BBBSC) to assess your eligibility as a volunteer. Your information will be stored and disclosed only as necessary, following privacy policies.

I confirm that I have read, understood, and agree to uphold the Offence Declaration, Confidentiality Policy, and Duty to Report obligations, including the responsibility to report child safety concerns as required by law.

Today's Date

August 12, 2026

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Annual Offense Declaration

Annual Offence Declaration Form - Feb 2026

1. OFFENCE DECLARATION:

2. CONFIDENTIALITY:

3. DUTY TO REPORT – CHILD SAFETY:

1. Are you a self-identified woman, non-binary, transgender or gender-diverse individual (age 19+) interested in becoming a volunteer?