• Courtside Care Registration Form

    Courtside Care is a free community event proudly presented by MLSE, Sun Life, and The Youth and Family Wellness Camp bringing together health, wellness, and basketball. Enjoy free health screenings and resources, connect with local health organizations, and take part in a free basketball clinic led by the Toronto Raptors Development Team.
  • Date of Birth*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Gender*
  • How do you Identify?
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Date
     - -
    2 digit month, 2 digit day, 4 digit year

  • I undersigned, do hereby grant permission to Makate Waagamichiwanang Gakinaa’amaatiwin - Youth & Family Wellness Camp, Ogimaawabiitong – Kenora Chiefs Advisory, the Ma’mo’weh Wii’soo’ka’tiwin foundation, and their partners to use my image.

    Such use includes the display, distribution, publication, transmission, or otherwise use of photographs, images, and/or video taken of myself (or my child if they are under 18) for use in materials that include, but may not be limited to, printed materials such as: brochures, newsletters, videos, advertisement (including billboard, digital and print) and digital images for our organization.

    I acknowledge these images have a potential to be advertised or promoted to organizations/partners outside of the region as well.

    I understand I have the right to inspect or approve the video or developed material.

    I understand that the Videos taken become the property of the organizations.

    I have read and understand the contents of this consent form.

  • Date
     - -
    2 digit month, 2 digit day, 4 digit year

  • I understand that, in all physical activities, there is a risk of physical injury and potential damage to property. 

  • I hereby give my consent for my child: (All should be checked off)
  • Date
     - -
    2 digit month, 2 digit day, 4 digit year
  • Should be Empty: