APPLICANT DECLARATION & AUTHORIZATION* By ticking the box below, I, the applicant named in this Form, declare and authorize that: • all information I have provided in this Form (collectively, “Information”) is true, correct and complete, and may be subject to verification by MTO; • MTO may rely on the Information in connection with its administration and delivery of the Course; • I will meet all Course requirements identified by MTO prior to the start of the Course, including a minimum attendance requirement of 80%; • I will complete each Course assignment, as directed MTO; • I grant MTO, including its funding agencies and any others it may authorize (“affiliates”), the right to collect and use my photograph, image and/or likeness, including audio and video recordings, and any comments made by or attributable to me (“Content”). I waive any rights related to such Content. I further grant MTO and its affiliates the right to modify, publish, or otherwise reproduce the Content, in all forms and manner, including in print and digital media, on its website, on its social media accounts (such as Facebook, Twitter and Instagram), in media releases, and in broadcasts, without payment or notice to me, in connection with its promotional, educational, funding and recruitment programs and materials. I acknowledge that MTO may, but is not obligated, to consult with me on the proposed use of the Content. I may withdraw my consent for use of my Content by providing written notice to MTO and understand that MTO will then make reasonable efforts to remove my Content under its direct control. I also understand withdrawal of consent does not have retroactive effect. I further release and hold harmless MTO and its affiliates from any claims or liability related to use of my Content; • MTO may share any of my Information and any information related to my participation in the Course with my employer, as identified in this Form, and any of its affiliates; • I was have read MTO’s Code of Conduct (available at https://www.nmto.ca/en/code-of-conduct) and agree to comply with its terms throughout the Course, in addition to the terms of any other MTO policy identified by MTO and made available to me, each as may be updated from time to time (collectively, the “MTO Policies”); • I may be expulsed from the Course if MTO determines, in its sole discretion, that I have breached any of the MTO Policies; • if approved for participation in the Course by MTO, I will promptly provide MTO with a fully executed version of the Sponsorship / Approval Form (available at the link below); • if any of my Information changes, or if I subsequently become aware of any errors or omissions in the Information, I will immediately notify MTO; and • I have carefully reviewed this Form and understand the above terms and agree to be bound by them. *

What ICS 200 is