This form applies to any Club Representative whose decision-making is influenced or could be influenced by personal, family, financial, business, or other private interests.
Your Name *
Your Email *
Position or Role with CVC: *
Please check all that apply and provide details where required. *
Details *
I understand that I have a continuing duty to disclose any actual, potential, or perceived conflict of interest that may arise during my service with CVC. I agree to comply with the CVC Conflict of Interest Policy and understand that failure to do so may result in disciplinary action, including removal from my role.
Signature *
Type your full name to sign this form.
Date *
Please verify that you are a human.
