Recording Consent Form

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* 1. Name

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* 2. Organization:

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* 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.

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* 4. I consent to the use of audio/video recording given the acknowledgements above:

I consent

I do not consent

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* 5. Signature:

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* 6. I acknowledge that by entering my name above I am providing a digital signature.

Agree

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* 7. Date

Date