COLLECTION OF INFORMATION STATEMENT In completing this Emergency Health Record form, in accordance with the provisions of the Act respecting Access to documents held by public bodies and the Protection of personal information (CQLR, c. A-2.1), the New Frontiers School Board must obtain your consent for the collection and use of certain personal information contained in this form regarding you or your minor child. If the child is under 14 years of age, only the person having parental authority or the legal guardian can consent. If the child is 14 years of age or older, the person having parental authority, the legal guardian or the child themself can consent. By completing and signing this form, you are consenting to the collection and use of personal information for the entire school year. This information will be used by employees of the New Frontiers School Board for whom such information is necessary for the discharge of their duties pursuant to section 62 of the Act respecting Access. Failure to provide consent may prevent you or your child from accessing school/centre/school board services. You may revoke your consent at any time. You have the right to access and correct this information once it will be in the possession of the New Frontiers School Board. It is important that you understand the scope of this consent request. Contact bcohen@rsb.qc.ca with you any questions in relation to this form.