Consent to Collect, Use and Disclose Personal Information
The information collected in this form is personal information (including but not limited to name, contact information, physical and behavioral characteristics, and traits) as defined by the Municipal Freedom of Information and Protection of Privacy Act, R.S.O.1990, c M.56.
Purpose for Collection & Use: The personal information is collected in accordance with the Police Service Act, R.S.O. 1990, c P.15, for the purpose of responding to incidents of missing persons, and to assist with the AMPS interaction with the Registrants where incidents may occur. Occasionally, the AMPS may refer to the personal information to better understand the Registrants' needs and how we can improve AMPS in relation to the Registrant.
Disclosure: The personal information collected may be disclosed to other law enforcement bodies for the purpose described above.
The retention, as well as any other use or disclosure, of this information will be dictated by the requirements under the Municipal Freedom of Information and Protection of Privacy Act, R.S.O. 1990, c M56
Questions: Questions about the collection, use or disclosure of the personal information may be directed to the Deputy Chief of Police at (613) 575-2340 or by email email@example.com
It is your responsibility to ensure that the information so collected is current and valid.
In consideration of the AMPS compliance with the collection, use and disclosure as set out above, I release, waive and forever discharge the AMPS Board, its employees and agents, and other law enforcement bodies from all claims, demands, damages, costs, expenses, actions, causes of action, whether in law or equity, resulting or alleged to result from your compliance with the foregoing authorization. I further waive any and all rights I may now or in the future have with respect to any disclosure of the personal information collected.
I agree that this is a completely voluntary sharing of information in the best interest of safety for the vulnerable person. This is to mitigate risk of harm but in no way guarantees safety or protects the individual from being accountable for criminal activity.
I declare that I am 18 years of age or older and that I have the authority to provide this personal information on behalf of the Registrant. I further declare that I have read the information provided above and I consent to the collection, use and disclosure of the personal information as described and the release described.
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Akwesasne Mohawk Police Service
PO Box 90, Akwesasne,
Quebec H0M 1A0