On the basis of an Information laid before me on oath by (Name of Informant) , a police officer with the (Name of Police Force) ,
under subsections 11(3) of Christopher’s Law (Sex Offender Registry), 2000, as amended,
I am satisfied that there are reasonable grounds to believe that (Name of Offender and Date of Birth (yyyy/mm/dd)) ,
(hereinafter the “offender”) is an offender within the meaning of subsection 1(1) of the Act, who was resident in Ontario and who was therefore obligated to present himself/herself at a designated bureau, police station or detachment of the police force where he/she resides or to another designated place in the area where the police force provides police services (hereinafter the “registration location”) on or before (Date Required to Register (yyyy/mm/dd)) , and failed to do so in violation of the Act and that it is reasonable and necessary to arrest the offender pursuant to subsection 11(3) of the Act for the purpose of having the offender comply with his/her obligation.
This warrant authorizes any police officer to arrest the offender for the purpose of bringing him/her to the registration location for the purpose of complying with his/her reporting obligation under the Act.
The offender shall be released forthwith after being brought to the registration location pursuant to this warrant.
This warrant may be executed anywhere in Ontario and is valid until it is executed.
Date (yyyy/mm/dd) and Time Judge or Justice of the Peace in and for the Province of Ontario (City, town, etc. where this Warrant is signed)