Media Release Form for Southern Gulf Islands Neighbourhood House (SGINH)

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The Southern Gulf Islands Neighbourhood House (SGINH) appreciates your participation in our programs and activities. To help us promote our community initiatives, we may take photographs, videos, or gather testimonials. By completing this Media Release Form, you consent to the use of your image, likeness, and/or testimonial in SGINH promotional materials.

Please complete the form below:

Full Name

Email Address

I confirm that...

I am over 18 and am providing consent for myself.

I am the parent or legal guardian of the individual in the media and have authority to provide consent.

I do not have the legal authority to provide consent.

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Consent to Media Use

By checking the box below, I hereby grant permission to the Southern Gulf Islands Neighbourhood House (SGINH) to use photographs, video recordings, and/or audio recordings of my participation in SGINH events or activities. These materials may be used in print, online, and other media for promotional purposes.

I consent to the use of my media as described above.

I do not consent to the use of my media as described above.

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