Kitchener Ice Pirates - Volunteer Information Form 2023/24, Kitchener Inclusive Hockey (Kitchener Minor Hockey)

Kitchener Ice Pirates - Volunteer Information Form 2023/24
Role of Volunteer

ON-ICE HELPER
Require the ability to skate themselves and teach children/ adults with Special Needs the fundamentals of hockey and skating. Also, to assist coaches/ players in performing drills.

Equipment Needed
Helmet, Hockey Gloves, Skates and Hockey Stick. 

OFF-ICE HELPER
Require either Organizational Skills, Computer Skills, the ability to Multi-Task and/or Fundraising skills. MUST be able to work well with Children/ Adults with Special Needs as well as their families. 

Certifications Required and Reimbursement Information - For Further Information - Click Here

Applicants confirm all information provided is accurate and if selected will adhere to KMHA and Inclusive guidelines and policies

Personal Information

Provide Contact Information

Certifications

List Any Hockey and Other Certifications. For links to Required Certifications, see top of application under Volunteer Role.

Police Check Declaration

I DECLARE, since the last Criminal Background Check collected by KMHA or the Kitchener Ice Pirates, as the case may be, or since the last Offence Declaration given to me by KMHA, that:

I 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).

Police Check Declaration Continued

Please Read Above Statement, Then Complete Section Below. Police Checks are required the first year, then every 3 years.

Other Information

Please Provide As Requested

Medical 

I understand that it is my responsibility to keep the team management advised of any change in the below information as soon as possible and that in the event no one can be contacted, team management will take myself/ my child to the hospital/M.D. if deemed necessary.

 

I hereby authorize the physician and nursing staff to undertake examination, investigation, and necessary treatment of myself/ my child.  

I also authorize the release of information to the Ice Pirates Coaches, Staff and appropriate people (Nurses, Paramedics, Physicians, etc.) 

Medical

Please Read Above Statement, Then Complete Section Below

Participants Permission for use of Participant's Photo's and/ or Name
Hockey Season: 2022/ 2023 Team Name: Kitchener Ice Pirates - Team GM/ Director: Kirsten Carr


At various times throughout the year, the Ice Pirates and/or Kitchener Minor Hockey may want to use various materials/sites to promote teams’ information, tournaments, and encourage communication through a message board. The team website and Facebook/ Instagram/ Twitter groups/pages are monitored. However the monitor and the Kitchener Minor Hockey Association together assume no responsibility for items posted on the message board and cannot prevent someone from posting a picture of a player or a volunteer onto the Internet. Participants should also understand the Internet can be viewed by anyone, anywhere in the world, thus making the image(s) and names very public. The Ice Pirates and/or Kitchener Minor Hockey occasionally names and photos for authorized marketing purposes, in team brochures and banners, and for other publicity events. The Ice Pirates and/or Kitchener Minor Hockey will also do their best to ensure all names and photos taken are not placed in any unauthorized newspaper or magazine. However, we often do not have control over this and thus do not assume responsibility for any articles or pictures printed.

By Clicking YES below, I give permission for the Kitchener Minor Hockey Association and/or the Kitchener Ice Pirates, to use my name and/or photograph. Volunteer, or Parent/Guardian if under 18, your Clicking YES indicates permission given.

I understand that name and/or image(s) may be posted on the above team’s website and will be linked to the Kitchener Minor Hockey Association website found at www.kitchenerminorhockey.com. The website may also be linked to other relevant hockey sites.

Media Release Form

Please Read Above Statement, Then Complete Section Below