I give permission to Forrest Green Solutions Ltd., on behalf of the Police Service, to collect my personal information - namely my name(s), gender, address(es), telephone number(s), place of birth, date of birth, current employer (optional), criminal record history (optional) and driver's licence (optional) - and to share it (except for my place of birth and criminal record history, if provided) with a licensed consumer credit reporting agency such as TransUnion or Equifax to authenticate my identity when applying online for a police record check. I understand and acknowledge that my personal information (except for my place of birth and criminal record history) will be shared with a consumer credit reporting agency and may update my consumer credit report.

I understand that even if I correctly answer all of the authentication questions, I may still be required to visit the police station. I further acknowledge that the Police Service may require me to complete a finger printing process at additional cost.

I understand and agree that if I abandon the authentication process at any point or do not successfully complete the questions or if the Police Service for any reason determines that my application cannot be completed I will not be refunded the amount already pre-paid.

I hereby release and discharge the Kentville Board of Police Commissioners and all members and employees of the Kentville Police Service from any and all actions, claims and demands for damages, loss or injury however arising which may hereafter be sustained by myself as a result of the disclosure of information by the Kentville Police Service. I hereby authorize the Kentville Police Service to inquire into and disclose the results of any police records to me including: outstanding entries, such as charges, judicial orders, peace bonds, probation and prohibition orders; criminal convictions (summary and indictable); absolute and conditional discharges; family court restraining orders; criminal charges resulting in dispositions including, but not limited to, withdrawn, dismissed, and cases of not criminally responsible by reason of mental disorder; police contacts including but not limited to theft, weapons, sex offences, or violent, harmful and threatening behavior, and to conduct a local police contact search with any police agencies in Canada.

I certify that the information provided by me in this application is true and correct to the best of my knowledge and belief. I have read this Consent, understand it, and agree to it in its entirety.

Personal information contained on this form is collected pursuant to the Municipal Freedom of Information and Protection of Privacy Act, s.28(2), s.32(b) and the Police Services Act, s.41 for the purpose of processing this police information check. Questions concerning this collection should be directed to the Kentville Police Service, Records Department, 80 River Street, Kentville, (902) 678-3378 or by email at [email protected].