Swim - Natation Manitoba (SNM)

Freedom of Information & Protection of Privacy Act

Consent Form

Club Name

Swimmer Name

PLEASE read carefully; completeandsignthisform.

AParent orLegal Guardian must sign forthose swimmers under theageof18.

The FederalPersonalInformationProtectionElectronicDocumentsAct(andequivalentprovinciallegislation)requiresthatconsent beobtainedpriortothecollectionanduseofallpersonalinformation.

Thepersonalinformationyouprovidetothe Clubfromthisregistrationwillbeused forthe purposesreasonablyassociatedwiththe swimmingactivitiesconductedbythe Club.Thesepurposesincludenational,provincialandeventregistration,insurancecoverage, trainingandcompetitionparticipationandcompetitionresultpublication.Someoftheinformationyouprovidewillbepassedonto Swimming/NatationCanada(SNC)andSwim Manitoba (SNM),forpurposesincludingassociationregistration,insurancecoverageand:

a)Ensuringswimmerstrainandcompeteinanageappropriateenvironment;

b)Establishingathleteeligibilityfor selectiontoswimteams;

c)Establishingpertinentmedicalrecords

d)Reportingnon-identifying,demographicandparticipationstatisticstofunders,sponsorsandotherauthorizedthirdparties;

e)Publishingathletes’names,genders,ages,clubaffiliationsonour webpagesorinresults,newsreleasesandranking

reports;

f)Makingdirectcontactwithswimmersas necessaryfortheoperationoftheClub,SNM andSNC.

Additionalpersonalinformationmaybecollectedfromtimetotime.Consentfortheuse ofthispersonalinformationmaybeinferred whereits usesareobviousandit hasbeenvoluntarilyprovided.Whennotobvious,thepurposesforcollectionwillbeprovidedprior to,oratthetimeofcollection;eitherorallyorinwriting.

CompletetextsofthePrivacy/PersonalInformationPolicies(variouslythe“Policy”or“Policies”)maybefoundforSNCat: Swim Manitobaat

Shoulda swimmerwishtoreviewtheirpersonalinformationheldbythe Club,SNM,orSNCtheymustmakea request totheappropriateorganizationpursuanttothatorganization’sPolicy. Further,swimmersmay withdrawconsenttousetheirpersonal informationpursuanttothePolicies.Suchawithdrawalhowever, mayrequirethecancellationofyourregistrationwithand suspensionofyouractivitieswiththe Club,SNMandSNC.

Allswimmersortheirlegalguardianmustsigna copyofthisform each season.

I herebyconsenttothecollectionanduseofpersonalinformationasdescribedabove.

SignatureofSwimmer(18orolder)Date

OrParent/Guardian