Name *

First Name

Last Name

Phone *

(###)

###

####

Consent - Please read fully *

Adult Waiver / Media Consent I hereby authorize any images, voice recordings or video footage taken of myself, in whole or in part, individually or in conjunction with other images, sound and video footage, to be displayed on the Voices of Hope Website, in physical exhibition(s) and other official channels, and to be used for media purposes including promotional presentations and marketing campaigns. I waive rights to privacy and compensation, which I may have in connection with such use of my name and likeness, including rights to be written copy that may be created in connection with video production, editing and promotion therewith.

I agree

Name *

Name of Youth

First Name

Last Name

Phone *

Parent/Guardian Phone

(###)

###

####

Consent - Please read fully *

Youth Video Waiver / Media Consent I hereby authorize any images or video footage taken of my youth (under 18 years of age), in whole or in part, individually or in conjunction with other images, voice recording and video footage, to be displayed on the Voices of Hope Website, in physical exhibitions, related events and other official channels, and to be used for media purposes including promotional presentations and marketing campaigns. I waive rights to privacy and compensation, which I may have in connection with such use of my youth’s name and likeness, including rights to be written copy that may be created in connection with video production, editing and promotion therewith. I am over 19 years-of-age and the parent or legal guardian of the youth, and I have read this waiver and am familiar with its content.

I agree