Skip to content

Copy of Niisaachewan Anishinaabe Nation Jordan Principle Consent Form

Consent Information

The information will be appropriately safeguarded, only used to apply for funding/ group applications for the child/ren of ages 0-18 (until they officially turn 18) specific and will not be disclosed for any other purposes. I understand the purpose for disclosing this personal and/ or educational information to the person noted above. I understand that there may be a limited usage of photos and videos. I understand that I can refuse to sign this consent form. 
1.I consent to release my children/ youth personal information for support towards group application process through Jordan Principle in accessing health, social and educational products, services and support they may need.(Required.)
2.Have consent on file for the year 2021-22 or until such time the child/youth is no longer in the primary care of the parent(Required.)
3.Permission to use photos or videos and / or the first name of my child/ren for the celebratory and promotional purposes.(Required.)
4.Please list each child: Full name & Date of Birth
5.Contact information
Current Progress,
0 of 5 answered