Media Release Consent Form printable pdf download

Media Release Consent Form

This consent form will authorise Outback Arts to use and print photographs and any

other form of media material for educational, informational and promotional purposes.

Images may be used, but is not limited to, Outback Arts publications and newsletters,

newspaper articles, advertising material, web listings, websites, etc.

This Media Release Form will be kept on file by Outback Arts as reference for individual

approval.

Individuals Full Name:____________________________________________________

Parent/Guardian’s Full Name (if individual is under 18 years):_____________________

_________________________________________

Relationship to individual:_________________________________________________

After reading the explanation above, I authorize Outback Arts to take and use any

photographs or media in any Outback Arts publication, production or presentation,

including electronic/internet marketing material for the purpose of promoting Outback

Arts in a positive manner.

Parent/Individuals Signature

______________________________________

Date

Outback Arts Inc. PO Box 28 Coonamble NSW 2829 Tel: 02 6822 2484 Fax: 02 6822 4159

.au

Media Release Consent Form