Student Principle Subject Consent Form

DISCLOSURE OF STUDENT INFORMATION

Your participation in an initiative that requires you to represent your program, School, Faculty, and the University of Waterloo, such as student ambassador roles, competitions, extra-/co-curricular activities (e.g. SIF, SVF, YTP, etc), student profile stories (written and digital), etc. may mean that your private student information (e.g. full name, program, program level, LinkedIn profile) may be made public as part of the promotion of the initiative. Your consent is required before the University of Waterloo may use your personal information in this way.

IMAGE & VOICE RELEASE

I hereby grant permission to the University of Waterloo and authorize the use by the University of Waterloo, its officers and employees, of my image, voice, and/or likeness.

I further grant the University of Waterloo and its representatives the right to reproduce, use, exhibit, display, broadcast, and distribute and create derivative works of these images and recordings in any media now known or later developed as well as my name, story, personal information including name (first name only for undergraduate students) for promoting, publicizing or explaining the University of Waterloo and its activities and for administration, educational, or research purposes. 

INFORMATION MANAGEMENT

The consent and permission you provide to the University of Waterloo through this form will be kept on record for one full academic cycle (12 months including co-op work term). The University of Waterloo will require you to provide consent and permission on an annual basis.

Student Initiative
Indicate the student initiative(s) you are providing consent and permission. Select all that apply
**The personal information contained on this form is collected and used pursuant to the Freedom of Information and Protection of Privacy Act, (under the authority of the University of Waterloo Act (1972); ,and will be used for the purpose of processing this application, assessing your suitability for participation in extra-curricular activities on behalf of the University and/or the University’s School of Accounting and Finance (SAF), as well as promoting your participation in such activities. Questions about this collection and use should be directed to Kaitlin O'Brien, kaitlin.obrien@uwaterloo.ca extension 47958. Questions about Information and Privacy at the University should be directed to the Privacy Officer at fippa@uwaterloo.ca.
Consent to publish social media information and name
The University of Waterloo, and the School of Accounting and Finance (SAF) in particular, is always interested in showcasing the efforts and achievements of our students, including by publicly publishing their names and, where appropriate, social media contact information on University websites. You are not required to consent to the University and/or SAF publicly publishing your name or social media contact information to participate extra-curricular activities associated the University and/or SAF; any such consent is entirely voluntary on your part. However, by checking any of the boxes below, you hereby irrevocably consent to and authorize the University, its officers, and its employees (including any employees of SAF), to publicly publish, exhibit, or otherwise display the information noted in the checked box, including publishing such information on University and/or SAF websites. You also agree to release the University from any and all liability associated with the University publishing, exhibiting, or otherwise displaying such information. I agree the University can publicly publish, exhibit, or otherwise display the following: Select all that apply.
To be considered for this role, you must be making satisfactory progress toward the completion of your degree. Additionally, you should not have serious incidents or allegations of misconduct as assessed by your Faculty’s Associate Dean. Note that minor infractions will not automatically exclude you from consideration. Each candidate is assessed on an individual basis. For clarity, you acknowledge that a University representative will review your student record for the purposes of processing this application, including your academic record and the campus incident systems reports, and you consent to such review. You also consent to a University representative reviewing your publicly accessible social media accounts to ensure consistency with University values.
**As a student who will be considered for a role (brand ambassador, experience story, competition, etc) in representing the SAF and UWaterloo, you must be making satisfactory progress towards the completion of their degree. Additionally, you should not have serious incidents or allegations of misconduct as assessed by your Associate Dean.** Note that minor infractions will not automatically exclude a candidate from consideration. Each candidate is assessed on an individual basis. ** Be as specific as possible, if there are additional criteria for assessment, include it here. **
I hereby waive any right to inspect or approve the use of images or recordings. I further waive all moral rights. I also waive any right to royalties or other compensation raising from or related to the use of the images or recordings. I hereby release, defend, indemnify, and hold harmless the University of Waterloo, its Board of Governors, officers, employees, or agents from and against claims, damages or liability arising from or related to the use of the images or recordings, including but not limited to claims of defamation, invasion of privacy, or rights of publicity or copyright infringement, or any misuse, distortion, blurring, alteration, optical illusion or use n composite form that may occur or be produced in taking, processing, reduction or production of the finished product, its publication or distribution.
I acknowledge that the University of Waterloo owns all rights to the images and recordings.
By completing and submitting this form...