All information is kept strictly confidential.
The warning signs of poor nutritional health are often overlooked. Read the statements below and select "yes" or "no" for each statement.
Please provide the name, phone number, and relationship of two individuals we can contact in the case of an emergency situation.
Aster Aging, Inc. regularly records our Senior Center programs and services. This may take the form of photos, video or audio recordings, digital images, and the like. Aster uses these on social media, advertisements, flyers, newsletter and more to promote our services and educate the public, in accordance with our mission. By participating in our activities, you understand and grant permission to Aster Aging to use your name, likeness, image, voice, and/or appearance as a program participant. Furthermore, I acknowledge that I will not receive any compensation for the use of such pictures, etc., and hereby release Aster Aging from any and all claims which arise out of or are in any way connected with such use.
Aster Aging, Inc. utilizes member email addresses to share important information, program activities, solicit feedback, and more. Communication can take the form, among others, of individual emails, group emails, and eNewsletters. While Aster will utilize your email address to communicate, we will never sell, share or trade your address to any outside organization. Your privacy is important to us!
My typed name below attests to the fact that I have read, understand, and agree to all of the above terms.
