Consent Form

CONSENT TO RELEASE INFORMATION

I authorize the Center for Family Support, Inc. (CFS) and its affiliates the right to use, reproduce, edit, and publish my name and all photographs, video, audio, and transcripts from agreed upon interviews. This authorization includes use in materials, including but not limited to, the website, social media, printed materials, or other CFS marketing tools. I agree that this authorization includes CF’s entitlement to use this information, without financial claim, in any and in all media in perpetuity.

If I am someone receiving support from CFS, I understand this may include information about the nature of my relationship with CFS and related information. If I am an employee, contractor, consultant, or someone with a business relationship with CFS, I understand that this authorization includes having such status with CFS.

Consent Form

MM slash DD slash YYYY

ACCREDITED WITH DISTINCTION

Like Us On Facebook

Sign Up For Our Newsletter

Follow Us