Jordan Dover

Email *

Participant's First Name *

Participant's Last name *

Participant's Preferred Name *

Participant's Pronouns *

He/Him

She/Her

They/Them

Participant's Age *

Gender *

Male

Female

Prefer not to say

Date Of Birth *

Grade Starting In September *

Does the participant have permission to sign themselves out of programming?

(Is your child allowed to leave programming on their own, or will they need to wait to be picked up?)

*

YES, my child has permission to leave programming on their own

NO, my child does NOT have permission to leave programming on their own

Parent/Guardian First Name *

Parent/Guardian Last Name *

Address: Street, (Unit/House Number Optional), City, Province, Postal Code *

Parent/Guardian Phone Number *

Emergency Contact (Full Name) *

Emergency Contact's Relationship to Participant *

Emergency Contact's Phone Number *

Physician's First and Last Name *

Physician's Phone Number *

List of Medical Concerns/Known Allergies (Please indicate if your child carries an epipen)

Do any of the following apply?

ADHD

Autism Spectrum Disorder

Intellectual disability

Mental Health Disability

Non-Visable disability

Sensory Overload

Visible disability

I give consent for my child or myself to be photographed at NeighbourLink North York Events *

Photography Release Form

I, _____________________________, hereby grant permission to NeighbourLink North York, including employees or volunteers, to photograph me [my child or children] during Youth Programming taking place throughout the summer of 2024 (July 9th- August 30th) at 415 Willowdale, North York and various other locations such as field trips .

I understand that the photographs captured may be used by NeighbourLink for promotional or educational purposes, including but not limited to:

Use on NeighbourLink's website and social media platforms:

1. Inclusion in newsletters, brochures, posters, and other print materials

2. Display at NeighbourLink's physical locations or public events

3. Sharing with media outlets or partners for public relations purposes

I acknowledge and agree that:

The photographs taken during the event/activity may be used without any further compensation or notification to me.

I understand that my consent is voluntary and that I have the right to refuse or withdraw my consent at any time.

Parent/Legal Guardian Consent:

I, the parent/legal guardian of ________________, grant permission for the minor to be photographed as described above. I have read and understood the terms of this Photography Consent and Release Form and agree to its terms on behalf of the minor.

Parent/Legal Guardian's Name:

*

Participant's Name *

Date of Registration *

Any additional information you would like us to know?

E-Signature *

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NeighbourLink North York Camp Registration Form

NeighbourLink North York Camp Registration Form

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