NFHCS Activity Release

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Completion of this form is required prior to attending events or classes at any Not Forgotten Home and Community Services locations.

Email *

Please enter the participant's first and last name (if you are a caregiver or completing this form on someone's behalf, please include your name a title as well) *

I confirm my acceptance that I shall hold harmless Not Forgotten Home and Community Services of Pittsburgh, its directors, agents, and employees from and against any and all losses, claims, liabilities damages, actions or expenses arising out of an accidental/unforseen/unintentional/other emergency event at our facility. (Type your full name below to confirm your acceptance) *

I hereby grant permission to Not Forgotten Home & Community Services, to use my name, artwork, photograph, or record of me on video for the purposes of endorsing the uniqueness of all individuals through inclusion and opportunity. I understand that my photograph/image may be used un a wide variety of promotional materials including newsletters, flyers, posters, brochures, advertisements, fundraising letters, annual reports, press kits, submissions to journalists, websites, social networking sites, and other print and digital communications. *

Yes, I grant this permission

No, I do not grant this permission

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