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    Movie Night

    October 14 @ 5:00 pm - 7:00 pm

    Community Connections - Movie Night

    PARTICIPANT INFORMATION

    Name(Required)
    DD slash MM slash YYYY

    Emergency Contact

    Name(Required)

    Required Information

    Address(Required)

    CONSENT

    LIABILITY WAIVER FORM AGREEMENT(Required)
    I give permission for my child mentioned above to partake in all activities of the Movie night as planned by HMC Connections. The Halton Multicultural Council, and other community partners*, therefore cannot be held liable for any accidents, injury, damage, or loss of personal possessions caused during the activities both on and off-site.
    CONSENT FOR RELEASE OF INFORMATION(Required)
    I, hereby authorize the HMC Connections to exchange & disclose my information internally with HMC programs. I have asked HMC for assistance and give full permission to disclose my personal information (if required) to IRCC & other applicable Service Providers for support, guidance, advocacy, information or referrals.
    MEDIA/ELECTRONIC/PRINT/PUBLICATIONS/COMMUNICATIONS RELEASE FORM(Required)
    I, the above named volunteer, student, employee, group, participant at the Halton Multicultural Council (HMC), unequivocally consent to the publication (including HMC social media accounts and website), release and transmission of the digital/electronic/print/photographs, to the extent that they may deemed necessary for express use thereof. This release and consent is voluntary. If you don’t wish to participate, there is no obligation on your part.

    SIGNATURES

    PARTICIPANTS 18 YEARS AND OLDER CAN SIGN THE REGISTRATION FORM THEMSELVES. PARTICIPANTS 17 AND UNDER MUST HAVE THEIR PARENT/GUARDIAN SIGN THE FORM.
    MM slash DD slash YYYY
    By typing my name below, I confirm that I have read and understood the information above.

    Details

    Date:
    October 14
    Time:
    5:00 pm - 7:00 pm
    Event Category:
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