Confidentiality: Any confidential information requested is for our records and for the funding our organization receives. The answers you provide will be kept strictly confidential. Your cooperation in providing this information is both appreciated and necessary. I/We authorize the Norris Square Community Alliance to have and use photographs, slides, moving pictures or television videotapes of the individuals named on this application as may be needed for its record or public relations program. I/We acknowledge that all the above information is accurate and that my decision to participate in the program is completely voluntary. I/We also agree that in the event that any information changes during the time of my/our participation at Norris Square Community Alliance, that I/We will inform the facility immediately.
I, the parent/guardian (head of household) on this application. for ourselves, our heirs, executors and administrators, hereby release. waive. acquit and forever discharge the Norris Square Community Alliance, their representatives, successors, insurers, assigns or any other person or entity associatedwith any of the above organizations such as staff. directors or volunteers, from all liability. claims, demands, or causes of action for any and all loss. damage. injury or death and any claim of damages resulting from use of facilities owned or controlled by the above organizations, or participation in activities of said organizations either at or away from the facilities.
Data Collection: I give my permission to the Norris Square Community Alliance to collect information via online or written surveys, questionnaires, interviews, and focus groups for all the household members on this application. Any and all information received will be kept strictly confidential. Data gathered through these means will be summarized in the aggregate and will exclude all references to any individual responses. The aggregated results of these analyses may be shared with organization staff, funders, and other community stakeholders to evidence program effectiveness and/or organization impact on our clients.
Technology: As a client of Norris Square Community Alliance. you and your family will have access to the Internet. While precautions are being taken. it is possible that you/your family may access inappropriate sites. Norris Square Community Alliance will have rules and consequences at the organization for such behavior; however, we will not be responsible for the consequences of such access.