ASA USE OF PERSONAL INFORMATION CONSENT2 FORM

ALBERTA SOCCER ASSOCIATION

USE OF PERSONAL INFORMATION CONSENT FORM

Athlete Name: _____________________ Parent / Legal Guardian Name: ______________________

I am the above-named athlete (the “Athlete”) of the legal age in Alberta or the parent or legal guardian of the Athlete under the legal age. The Athlete is given the opportunity to participate in certain events, including games and training sessions (the “Events”), governed by the Alberta Soccer Association (“ASA”).

I acknowledge and understand that my and the Athlete’s Personal Information will be protected and managed in accordance with ASA’s Privacy Policy and the Personal Information Protection Act (“PIPA”), and made available only to the staff of ASA and Soccer Canada. Personal Information is any information about an individual that relates to the person’s characteristics including, but not limited to: gender, age, income, home address, home phone number, ethnic background, family status, health history and health conditions.

I hereby authorize ASA to collect, store, and use my and the Athlete’s Personal Information for reasonable purposes including, but not limited to, the following:

• Identifying you and the Athlete;
• Management of ASA’s operations;
• Development and enhancement of program offerings;
• Promoting ASA; and
• Statistical purposes.

I understand that should I choose to withdraw this authorization, I shall communicate my withdrawal to ASA in writing. I am of the legal age in Alberta or I am the parent or legal guardian of the Athlete under the legal age and before signing this document, I have read it completely and fully understand it, and that I am bound to its terms, including my heirs, personal representative and assigns.

Signature: Parent / Legal Guardian ____________________________

Print Name: ____________________________

Contact Telephone Number: ____________________________

Date: ____________________________

OPT OUT VERSION

ALBERTA SOCCER ASSOCIATION

USE OF PERSONAL INFORMATION CONSENT FORM

Athlete Name: _____________________ Parent / Legal Guardian Name: ______________________

I am the above-named athlete (the “Athlete”) of the legal age in Alberta or the parent or legal guardian of the Athlete under the legal age. The Athlete is given the opportunity to participate in certain events, including games and training sessions (the “Events”), governed by the Alberta Soccer Association (“ASA”).

I acknowledge and understand that my and the Athlete’s Personal Information will be protected and managed in accordance with ASA’s Privacy Policy and the Personal Information Protection Act (“PIPA”), and made available only to the staff of ASA and Soccer Canada. Personal Information is any information about an individual that relates to the person’s characteristics including, but not limited to: gender, age, income, home address, home phone number, ethnic background, family status, health history and health conditions.

I acknowledge and understand that by agreeing to participate in the Events, I consent that ASA may collect, store, and use my and the Athlete’s Personal Information for reasonable purposes including, but not limited to, the following:

• Identifying you and the Athlete;
• Management of ASA’s operations;
• Development and enhancement of program offerings;
• Promoting ASA; and
• Statistical purposes.

I understand that by not opting out within reasonable time, I am deemed to be consenting to the above. In the situation that I choose to withdraw my consent at any point, I shall communicate my withdrawal to ASA in writing.

I am of the legal age in Alberta or I am the parent or legal guardian of the Athlete under the legal age and before signing this document, I have read it completely and fully understand it, and that I am bound to its terms, including my heirs, personal representative and assigns.