BIG on STEM 18+ Registration

I, ,hereby provide my consent to participate in Big Brothers Big Sisters of Grande Prairie & Area's BIG on STEM program. I agree that it is my responsibility to get myself to and from the program location. I am fully aware and agree to the following: In the event that I become ill, I will not attend the event. I agree that Big Brothers Big Sisters of Grande Prairie & Area (hereafter known as BBBSGP) will not be responsible for any injuries I may sustain from/while participating in any BBBSGP programs or while on BBBSGP property. I authorize the senior staff member present on-site to seek medical attention for myself in the event of an injury or sickness. In consideration for this service and other valuable consideration provided to myself by BBBSGP, I release the agency of all responsibilities and liabilities in connection to their services provided in good faith, to myself. I permit the agency to release any relevant information, including my personal information, to Big Brothers Big Sisters of Canada (hereafter known as BBBSC) and their insurers, as may be appropriate in connection with any legal proceeding, inquiry or risk thereof. Without limiting the generality of the foregoing, the participation by myself in connection with my involvement withBBBSGP exposes me to certain risks, including the risk of contracting Covid-19 which may result in serious illness or death. I assume all risks associated with therewith including the risk of contracting Covid-19 and hereby release all BBBSGP and BBBSC. I understand that all data collected will adhere to the Freedom of Information and Protection of Privacy Act and Personal Information Protection Act.

Big Brothers Big Sisters of Grande Prairie & Area believes in maintaining high standards of ethical conduct in the operation of the agency’s programs and the representation of them to the community, including a commitment to privacy and confidentiality within the limitations defined by law. The Agency adheres to all applicable Federal and Provincial Privacy legislation and is committed to protecting the professional and personal privacy and confidentiality of its volunteers, youth, and their families. All individuals in a position of trust within the agency are required to sign a privacy/confidentiality agreement. This includes staff and volunteers. It is important to understand that information will be shared with other staff only as needed for service to yourself. Care will be taken that information to any involved professional outside of the agency is only released if relevant only to the agent’s specific needs and as necessary for the best care of yourself or family, and only with the signed consent of yourself except in the case of concern of child abuse or neglect, where staff are required by law to inform the proper authorities, which could result in the disclosure of confidential information. If subpoenaed to a trial, hearing or proceeding, Agency staff members are again required by law to disclosure. The names of the youth and/or their parents concerned in any judicial proceeding shall not be shared outside the agency