Confidentiality AgreementPlease enable JavaScript in your browser to complete this form.Every person in our program owns any or all information about themselves. To make sure that everyone feels comfortable about sharing their personal stories and experiences to other participants we ask that you share responsibility for maintaining the confidentiality of our program. We can all do this by making sure that what is said in the centre stays in the centre. Please read and check beside each of the lines below: No written record will be kept about anyone's personal information unless you ask us to do so, except for registration information & dietitian services. *No written record will be kept about anyone's personal information unless you ask us to do so, except for registration information & dietitian services. Staff members, partners and volunteers of the Skookum Jim Friendship Centre agree to keep all personal information only as necessary within the circle of confidentiality. If you don't want other staff to know about your situation, please let us know. *Staff members, partners and volunteers of the Skookum Jim Friendship Centre agree to keep all personal information only as necessary within the circle of confidentiality. If you don't want other staff to know about your situation, please let us know. If you wish, you can give permission for us to discuss with others what you have shared with us. You can say exactly who else gets to know what you have shared. *If you wish, you can give permission for us to discuss with others what you have shared with us. You can say exactly who else gets to know what you have shared. If the information you share is about child abuse or harm to others or yourself we are required to contact appropriate assistance and we will invite you to contact them with us. *If the information you share is about child abuse or harm to others or yourself we are required to contact appropriate assistance and we will invite you to contact them with us. Any information shared among group participants must be kept strictly private. Do not discuss other participants' information outside of the group *Any information shared among group participants must be kept strictly private. Do not discuss other participants' information outside of the group Name *Terms and Conditions *I have read the above policy and agree to abide by the terms and conditions stated above.LayoutSignature *Clear SignatureDate *Submit