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Crescent Beach Swimming Club ("CBSC")
Personal Information Protection Act - Notice and Consent

Please read this Notice and Consent carefully and if you agree, indicate your agreement by consenting below.

CBSC members under 19 years of age must have parental or guardian consent.

The Personal Information Protection Act of BC (the “Act”) requires in certain circumstances that consent be obtained for collection, use and disclosure of personal information (which may include the taking of individual and group photos, the listing of achievements, the use of names in the newspaper, club, regional, or provincial association websites, internet, listing of names, club, age, gender, etc. in publications of results and entries in meets, tournaments, etc.).

A listing and brief description of these activities is outlined in the Notice section below (collectively, the “Personal Information”). 

I. Consent:

I hereby consent, on behalf of myself and all my children under the age of 19 (as listed below, if any), to the collection, use and disclosure of the Personal Information.

II. Notice:

The collection, use and disclosure of certain personal information by or on behalf of CBSC, its officers, directors, employees, representatives and agents, including volunteers, will be for: club, regional and provincial association communications and administration, registering and placing CBSC members for activities, registration, pre-meet registration, results (in all media formats), CBSC and provincial records and related or incidental activities permitted by the Act. Except as permitted by the Act, personal information collected from or pertaining to CBSC members will be kept private and confidential, unless authorized in writing by the CBSC
member or the CBSC member’s parent or guardian. The activities for which consent is requested include, but are not limited to: 

  1. individual photos that are taken;
  2. photos or videos that are used in electronic or print media;
  3. the use of the CBSC member’s name, gender and/or age and description of activities (i.e. event and results) in CBSC newsletters and other communications, in print form, electronic or otherwise; 4. the use of the CBSC member’s name, gender and/or age in team lists or databases to enable clubs to send data to CBSC; and/or
  4. other related or incidental activities within CBSC or the community. 

Please note that consent is not required with respect to information that is collected by observation at a sport meet or similar event. Photos and/or videos of activities that are open to the general public may be taken and used for purposes within and outside CBSC or the community. CBSC may not restrict such activity at public events. 

June 10, 2023

First Participant's Name

First Name*

Middle Name

Last Name*
First Participant's Date of Birth*
I certify that I am 19 years of age or older
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

Last Name*
Second Participant's Date of Birth*
Third Participant's Name

First Name*

Middle Name

Last Name*
Third Participant's Date of Birth*
Fourth Participant's Name

First Name*

Middle Name

Last Name*
Fourth Participant's Date of Birth*
Fifth Participant's Name

First Name*

Middle Name

Last Name*
Fifth Participant's Date of Birth*
Sixth Participant's Name

First Name*

Middle Name

Last Name*
Sixth Participant's Date of Birth*
Seventh Participant's Name

First Name*

Middle Name

Last Name*
Seventh Participant's Date of Birth*
Eighth Participant's Name

First Name*

Middle Name

Last Name*
Eighth Participant's Date of Birth*
Ninth Participant's Name

First Name*

Middle Name

Last Name*
Ninth Participant's Date of Birth*
Tenth Participant's Name

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.

Parent(s) or Court-Appointed Legal Guardian(s) must sign for any participating minor (those under 19 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.




By signing below the Parent or Court-Appointed Legal Guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*
Parent or Guardian's Date of Birth*
I certify that I am 19 years of age or older
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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