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Declaration of Interests Form
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Each Calisthenics Victoria (CaliVic) Officer is required to disclose in writing any professional or personal relationships or interests that may give rise to an actual, potential, or perceived conflict of interest. An interest can be direct or indirect. An interest can also be financial or non-financial. Definitions: Conflict of Interest - a conflict between a CaliVic Officer’s duty to act in the interests of the organisation and personal interests. Conflict of Duty - a conflict between a CaliVic Officer’s duty to act in the interests of the organisation and duty to another organisation i.e. ‘wearing two hats’. Direct Interest - is held by a CaliVic Officer. Examples include (but are not limited to) employment, business interests, club/committee/competition affiliations and associations. Indirect Interest - is held by a relative or close associate (including an enemy) of the Officer. Examples include (but are not limited to) partner, friend or family members’ interests. In either a conflict of interest or conflict of duty, a conflict exists whether it is actual or real (it currently exists), potential (it may arise) or is perceived (a reasonable person could believe that it exists or may arise). CaliVic Officer’s may be aware of existing conflicts of interest or become aware of potential conflicts of interest through their involvement in CaliVic meetings or through other means.
My CaliVic role is*
I declare the following direct and/or indirect relationships or interests that may give rise to an actual, potential or perceived conflict of interest with my duties as a CaliVic Officer*
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Do you have any Direct interests or relationships*
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Please list your Direct interests or relationships (if applicable)
Do you have any Indirect interests or relationships*
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Please list your Indirect interests or relationships (if applicable)
I declare that to the best of my knowledge, the information I have provided in Part A and Part B of this declaration is true and correct. I undertake to advise CaliVic if an actual, potential or perceived conflict arises in the future and to stand down in any decision-making process in which I may be compromised. If there is any change to the interests set out in this declaration, I undertake to advise CaliVic of any alterations or additions to my declaration as soon as practicable.
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