IYI Conference Registration – Parent Section By clicking the "Yes" boxes below, you give consent for your student applicant to participate in an Indigenous Youth Conference organized by WISE NL. Submission of this form is required to complete a student's application to participate in the conference. STUDENT APPLICANT INFORMATION Student Applicant's Name: Date of Birth (mm/dd/yyyy): Name of High School: PARENT/GUARDIAN CONTACT INFORMATION I affirm that I am a parent/guardian of the above-named student applicant. YesNo Parent/Guardian Name: Today's Date: Parent/Guardian Email: Full Address: Best phone number to reach you: Next best phone number to reach you: CONSENT TO PARTICIPATE I grant permission for my student applicant to participate in this year's Indigenous Youth Conference organized by WISE NL. YesNo IMAGE AND RECORDINGS RELEASE I authorize WISE NL to use: Photographs (both individual and group) in which my child may be identified by name. Sound recordings of my child Interviews of my child Printed material written by my child For use in: Promotional initiatives such as website, reports, and other WISE NL programs and brochures for WISE NL and Memorial University of Newfoundland. Media releases such as paper, newsletters, magazines, etc. I agree not to hold WISE NL responsible for the content of such photographs, sound recordings or interviews or the specific use to which they may be applied. I understand I have the right to refuse to grant this authorization now or to revoke authorization at any time. Compliance is voluntary. Consent remains valid until withdrawn. By clicking the "Yes" box below, you agree to the above conditions regarding image and recording release. YesNo ----------- What's Next? After clicking on the "Submit" button, this information will be sent to the IYI organizers and a copy emailed to you. The information is not otherwise retained on our website. Once the email is received by the IYI organizers, the information is considered confidential. If you wish to change any information, follow the instructions in the acknowledgement email.