Recording Consent Form Question Title * 1. Name Question Title * 2. Organization: Question Title * 3. Acknowledgements: I grant permission for the organization named above to record audio and/or video of me for any of the following purposes: websites or social media accounts, advertisements, promotional publications, articles, other marketing materials, and internal publications. I understand that the recordings used online may freely be shared by anyone who has access to internet connectivity and may be published to a local press or media. I can withdraw the consent I have given at any time. However, I understand that any recordings already published may not be able to be fully removed from existing materials. I confirm that I am of legal age to give my consent. Question Title * 4. I consent to the use of audio/video recording given the acknowledgements above: I consent I do not consent Question Title * 5. Signature: Question Title * 6. I acknowledge that by entering my name above I am providing a digital signature. Agree Question Title * 7. Date Date Date Done