American Indian/Alaska Native & Indigenous Services

CONSENT FOR PHOTOGRAPHS OR VIDEO RECORDING 

We would like to celebrate your participation and/or your child's participation in our programs and activities and are requesting permission to allow staff to take your and/or your child's photo and/or video and record you and/or your child as you participate in activities coordinated by the American Indian/Alaska Native & Indigenous Services staff and contractors. 

By selecting YES and entering your full name, you, the youth’s parent or guardian, understand that you are giving your consent to allow American Indian/Alaska Native & Indigenous Services Staff to take pictures and/or video record as you and/or your youth participate in the activities. You also understand that these photos and videos of you and of your child may be used for marketing purposes in print publications, presentations, and social media to promote services for the Sacred Path Indigenous Wellness Center. 

You do not have to give consent to photography and/or video recording if you do not wish to do so. This will not affect your participation in our activities and services. 

Dual Enrollment Agreement
By signing up for services with AIANI, you acknowledge and agree that you are also enrolling in services provided by Sacred Path Indigenous Wellness Center. This partnership ensures access to a broader range of resources and support. By completing this application, you consent to the sharing of relevant information between AIANI and Sacred Path Indigenous Wellness Center as necessary to facilitate services, in accordance with applicable privacy laws and regulations.

The participant (named in previous page) and the authorized representative(s) authorize American Indian/Alaska Native & Indigenous Services to provide support service(s) (referral services and linkages) and cultural activities. I may cancel this consent at any time.