Media Consent Form Name(Required) First Last Are you under the age of 18 and require parent/guardian consent?(Required) YES, I am under the age of 18 NO, I am 18 or older Name of Parent or Guardian(Required) First Last Email(Required) Enter Email Confirm Email Would you like to be tagged on Instagram? Yes, please tag me No, thank you Instagram UsernameThis does not guarantee that you will be tagged in any content, but we will retain your information just in case.Would you like to be tagged on any other platforms? Yes, please tag me No, thank you Please note the platforms, username or URL that you may want tagged.This does not guarantee that you will be tagged in any content, but we will retain your information just in case.Consent(Required)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. I agree to the media consent policy.Parent or Guardian Media Consent(Required)I, the undersigned, give permission to the Centennial College Student Association Incorporated (CCSAI), and/or parties designated by the CCSAI to photograph/video my minor 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 minors 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. I agree to the media consent policy. Statement on Privacy and Data Collection All submissions are kept in strict confidence. Data will be safeguarded at all levels to protect against damage, loss, and breaches of security. Access and use of data will be granted internally when a legitimate need for the data is demonstrated and appropriate approval given. Data will only be used for the purpose for which use has been authorized. Data shall be stored in such a way as to ensure that the data is secure, and that access to data is limited to authorized users. If there are any questions or concerns about our data collection and storage methods, please reach out to us at [email protected].Please Confirm: I have read and accepted the Privacy & Data Collection Statement.
