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Medicine Hat Police Service
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Police Consent to Disclosure Statement

I consent to the Medicine Hat Police Service (the "Police Service") conducting the following searches about me:
  1. Criminal convictions, conditional and absolute discharges and other related information about me contained in Canada's National Repository of Criminal Records.
  2. Criminal and provincial statute dispositions and any pending criminal or provincial statute charges before the Alberta courts as identified in the Justice Online Information Network.
  3. Current court orders, warrants, prohibition orders, probation orders, peace bonds, recognizance orders in Alberta and current outstanding out of province warrants identified in the Canadian Police Information Centre.
  4. Information obtained from local police records, which may include a query of the Police Information Portal, in which I was the subject of a police investigation where a risk to public safety exists. A decision to disclose information described here in section D will be made by the Police Service upon consideration of several factors including the nature of the responsibilities of the position applied for, the individuals with whom I will be interacting, the frequency and recency of the occurrences, any demonstrated patterns of behaviour and the reliability of the information contained in the records.

  1. Vulnerable Sector Check: completed when required by the Requesting Agency because you will be responsible for the well-being of children, the elderly, people with disabilities or other vulnerable populations. It is the Police Service that determines or verifies that the position you are applying for meets the requirements for a vulnerable sector check.

    A Vulnerable Sector Check is required when you will be in a position of trust or authority over vulnerable persons including children, the elderly and people with disabilities. A Vulnerable Sector Check involves a search of the automated criminal records (pardoned sex offender) retrieval system maintained by the RCMP to identify the existence of sex offences for which a record suspension or pardon exists. A Vulnerable Sector Check also includes a search of local police records to determine if any patterns of behaviour exist that may result in harm to a vulnerable person.

    I consent to a search being made in the automated criminal records retrieval system maintained by the Royal Canadian Mounted Police to find out if I have been convicted of, and have been granted or issued a pardon for, any of the sexual offences that are listed in the schedule to the Criminal Records Act.

    I understand that if, as a result of giving this consent, a search discloses that there is a record of my conviction for one of the sexual offences listed in the schedule to the Criminal Records Act in respect of which a pardon was granted or issued, that record shall be provided by the Commissioner of the Royal Canadian Mounted Police to the Solicitor General of Canada, who may then disclose all or part of the information contained in that record to a police force or other authorized body. That police force or authorized body will then disclose that information to me.

    I understand that the Police Service will not disclose this information to the Requesting Agency without further consent from me.

    I acknowledge that I understand when a Vulnerable Sector Check is required and, if required, I consent to the Vulnerable Sector Check.


A police record consists of information created or gathered by police. It may include information such as criminal charges and convictions, non-conviction information such as acquittals, findings of not criminally responsible by reason of mental disorder, stays of proceedings, participation in alternative measures and other diversionary programs, investigations, and occurrences that did not result in charges being laid. A police record may also include non-criminal contact with police. Even if you have never been charged or convicted of an offence a police record may exist as a result of an interaction with the police, including interactions due to mental health issues or as a result of an investigation conducted by police, whether you knew about the investigation or not. Information created or gathered by police is retained in accordance with the Police Service's records retention schedule. If you require further information about the Police Service's retention schedule, please contact the Police Service responsible for completing your Police Information Check.

I give my consent to the Police Service to use any and all information about me that it has found after completing the above identified searches, including information obtained from local police records, to complete a Police Information Check and I give my consent to the Police Service to disclose the results of the searches to me in a Police Information Check. I understand that it is my decision whether I provide the results of the searches to any other person or organization. I understand that further information about the Police Information Check process is available in the Alberta Police Information Check Disclosure Procedures which are available on the Police Service's website.

I remise, release and forever discharge the Police Service, the Chief of Police of the Police Service, the Police Service's Police Commission, and all of their administrators, successors, assigns, agents, officers, servants and employees from any and all demands or claims of every nature and kind at law or in equity including, without limitation, all manner of actions, suits, debts, dues, general damages, special damages, pecuniary damages, costs or interest, incurred by me or my legal representatives, heirs, assigns or agents and arising from or in any way related to my participation in the Police Information Check process and the obtaining of a Police Information Check.

The information collected, used and disclosed as part of this Police Information Check process will be collected, used and disclosed in accordance with the Freedom of Information and Protection of Privacy Act or as otherwise provided by law.

By accepting this electronic consent, I confirm that I have fully informed myself and understand the content, meaning and effect of this consent and release of liability and I declare that the information provided by me is accurate and may be verified by the Police Service through police information databases if required.