Media Opt-Out – Child/Youth Media Opt-Out - Child/Youth This form is to be used for any participants, volunteers or individuals who are 18 years of age or younger at the time of consent and signature. Date(Required) MM slash DD slash YYYY Child/Youth Name(Required) First Last Parent/Guardian Name(Required) First Last Parent/Guardian Phone(Required)Parent/Guardian Email(Required) Media Opt-Out(Required) I do not offer permissionI hereby do NOT offer permission to Big Brothers Big Sisters of Victoria Capital Region (BBBSV) producing video, images, audio and/or written quotes including my child/youth. Please do NOT produce, record or share any type of media including my child/youth due to confidentiality, safety, privacy or other concerns.
