"*" indicates required fields NameThis field is for validation purposes and should be left unchanged.I, the undersigned, consent to the use of my name, image, likeness, voice and/or video recordings for any lawful purpose publication, videotape, pamphlet undertaken by Technology for Living including, but not limited to activities such as promotions, advertising, fundraising and reporting. Furthermore, I understand that my name, likeness, image, voice and/or video recordings may be used by Technology for Living in various media formats including but not limited to images, videos, audio recordings, publications, newsletters, podcasts, and social media posts. I also understand that TFL will not compensate me in any way for the publication or use of my image, likeness, voice, name and/or video recording. In addition, I release Technology for Living from all liability, claims, demands, actions, causes of actions arising out of or related to the use of my name, likeness, image, voice and/or video recordings, including any claims of invasion of privacy. It is also my understanding that I can opt out of having my name, image, likeness, voice and/or video recording used by TFL by contacting them in writing and making this request. By signing this Media Consent, I certify that I am the age of majority in British Columbia and have read and understood the terms contained within. If I am under the age of majority, my parent or legal guardian is signing on my behalf and has read and understood this media consent and is providing consent on my behalf. Full Name*Phone*Email* Address* Street Address City Province AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Postal Code Upload File(s) Drop files here or Select files Max. file size: 128 MB. Name of Parent or Legal GuardianIf this release is obtained from a presenter under the age of 19 or a person with disabilities unable to sign, then the name of that presenter’s parent or legal guardian/representative is also required.Aggreement* I agree and understand that TFL accepts no obligations or financial responsibilities if a photograph is used.
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Furthermore, I understand that my name, likeness, image, voice and/or video recordings may be used by Technology for Living in various media formats including but not limited to images, videos, audio recordings, publications, newsletters, podcasts, and social media posts.
I also understand that TFL will not compensate me in any way for the publication or use of my image, likeness, voice, name and/or video recording. In addition, I release Technology for Living from all liability, claims, demands, actions, causes of actions arising out of or related to the use of my name, likeness, image, voice and/or video recordings, including any claims of invasion of privacy.
It is also my understanding that I can opt out of having my name, image, likeness, voice and/or video recording used by TFL by contacting them in writing and making this request.
By signing this Media Consent, I certify that I am the age of majority in British Columbia and have read and understood the terms contained within. If I am under the age of majority, my parent or legal guardian is signing on my behalf and has read and understood this media consent and is providing consent on my behalf.
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PROP: 1-866-326-1245 TIL: 604-326-0175 info@technologyforliving.org
