Board Intake Form

I, the undersigned, give permission to the Centennial College Student Association Incorporated (CCSAI), and/or parties designated by the CCSAI to photograph/video me and use such photograph(s)/video(s) in all forms of media, for any and all promotional purposes including advertising, display, audiovisual, exhibition or editorial use.

I further consent to the use of my name in connection with the any photograph(s)/video(s) if needed by the Centennial College Student Association Incorporated and/or parties designated by the CCSAI.

I understand and agree that I will not receive any payment for my time or expenses or any royalty for the publication of the photograph(s)/video(s) or the use of my name and I hereby release the Centennial College Student Association Incorporated and/or any parties designated by the CCSAI from any such claims.

I certify that I have read and fully understand this consent and release and that all questions pertaining to this consent have been answered to my satisfaction.