• Get Started! Call 780-434-3698

Information Release Consent

Release of Information Form

Student's Name(Required)
I authorize staff from the Centre for Literacy to share information about my child with the following:
I understand that this authorization may be rescinded or amended at any time by written, dated communication. I understand that my authorization will remain effective from the date of my submission until such time as my child 1) ceases to receive support at the Centre for Literacy, 2) the authorization is replaced, or 3) the authorization is rescinded. Information will be handled confidentially in compliance with all applicable federal laws.