Community Accountability Programs Information ... - Ministry of Justice

Sample FormCOMMUNITY ACCOUNTABILITY PROGRAM AGREEMENTI, _______________________, freely and voluntarily agree to participate in the_______________________________ program on the ____ day of _______________,20___.I acknowledge responsibility for the offence of __________________________________________________________ occurring on the ____ day of _______________, 20___.I was apprised of my right to legal counsel and was given reasonable opportunity to contactlegal counsel prior to participating in the program.I freely and voluntarily agree to the following terms and conditions resulting from myparticipation in the __________ program:______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________I understand that if I do not complete the terms of this agreement, this information will beforwarded to the referring police officer and may be recorded on my police file.Dated this ____ day of _______________, 20___ at ____________________ BritishColumbia.Offender signature: ___________________________Parent/guardian signature (if applicable): __________________________________Victim/complainant signature: ___________________________________________Program representative signature: _______________________________________Investigating officer signature: __________________________________________