1. I declare that I have never had an application submitted on my behalf rejected for, nor have I been suspended or dismissed from, a position in a sport, volunteer, business, educational or other Government or semi-government organisation, where that rejection, suspension or dismissal relates to my conduct with a person aged under 18 years, or to violence, drug us or dishonesty.
2. I declare that are no other matters relating to me which a reasonable person would consider relevant to the fitness of a person to be involved with athletes aged under eighteen or an administrator with frequent contact with persons aged under 18.
3. I agree to notify Lacrosse Australia's CEO or National Integrity Manager if any rejection, suspension, dismissal or matter referred to in item 1 or 2 arises in future.