Media Consent Form – Adult 19+ Media Consent Form - Adult 19+ This form is to be used for any participants, volunteers or individuals who are 19 years of age or older at the time of consent and signature. Date(Required) MM slash DD slash YYYY Name(Required) First Last Phone(Required)Email(Required) Media Consent(Required) I consentI hereby consent to Big Brothers Big Sisters of Victoria Capital Region (BBBSV) producing video, images, audio and/or written quotes including myself. I understand that this media may be used at BBBSV's discretion on the organization website, email newsletter, social media channels, promotional materials such as brochures and posters, YouTube channel, print advertising, grant applications and reports, print advertising, and/or other local marketing initiatives. I acknowledge that this media will NOT be released for use by the national Big Brothers Big Sisters of Canada organization without my additional informed consent and signature.
