INDIVIDUAL MEMBER DECLARATION

  1. I hereby authorize:

    (i) the Student Canadian Chiropractic Association-Chapter (the “SCCA”) to collect and use my personal information, including my: name, contact information (including home address, email address and telephone number), membership number, and program-related information (including name of school and program, and year of program) (collectively, “Personal Information”), for the purpose of administering my membership in the SCCA, providing me with membership services and benefits, communicating with me, internal management, including accounting, administration and compliance, and otherwise establishing, maintaining and managing its relationship with me (the “Purpose”);

    (ii) my Personal Information to be shared: (a) by the SCCA (“SCCA”), the Canadian Chiropractic Association (“CCA”) and the school at which I am a chiropractic student (the “School”); a CCA, respectively, for the purposes of administering the relationship of the SCCA and/or CCA, as the case may be, and otherwise for the Purpose;

    (iii) SCCA and CCA to collect and use my Personal Information for the purposes described above in paragraph (ii); and

    (iv) the SCCA and CCA to send me communications, by mail or email, about the SCCA and CCA and/or other information that may be of interest to me in my capacity as a member of the SCCA.

    To: (1) withdraw your consent to the collection, use or disclosure of your Personal Information; (2) unsubscribe from communications from the SCCA and/or CCA; and/or (3) learn about the implications of withdrawing your consent and/or unsubscribing from communications, please contact the SCCA privacy officer.
  2. I hereby:

    (i) acknowledge that I have read and agree to support the objectives, including the policy statements,
    of SCCA and CCA;

    (ii) the consents given herein with respect to my Personal Information are in addition to and not a
    substitution for the rights and requirements imposed on the School, the SCCA and CCA under
    applicable privacy legislation; and

    (iii) agree to conduct myself at all times in accordance with the SCCA bylaws.