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Photo Release Form - Adult

Standard Consent Form for Adults

I hereby give The Corporation of the Municipality of Central Huron (the “Municipality”), its employees, agents, assigns and legal representatives the irrevocable right to use my name, photograph, image, audio recording, video recording and likeness (collectively, “My Image”) in all forms and manner, including but not limited to, publication on Municipality-owned and non- Municipality-owned property, print media, digital media, the Internet, social media sites, media releases and broadcasts, without further notification to you. I understand that the Municipality cannot control unauthorized use of My Image by persons not associated with the Municipality once My Image has been published. I hereby forever waive any right to inspect or approve any publication of My Image by the Municipality. I hereby forever release and waive any and all claims I may have or ever have against the Municipality, its elected officials, employees, agents, assigns and legal representatives for the use of My Image.

I have carefully reviewed and understand the above provisions and agree to be bound by them. I voluntarily and irrevocably give my consent and agree to this release and waiver.
 

Note: The information on this form is collected under the authority of the Municipal Freedom of Information and Protection of Privacy Act, R.S.O. 1990, CHAPTER M.56, as amended, to obtain your consent for the use of your name, photograph, image, audio recording, video recording and likeness. For further information please contact clerk@centralhuron.com.