Photography / Film / Text Consent Form For Kirikiriroa Family Services Trust

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Kirikiriroa Family Services Trust would like to take photos and/or video of either you and/or those in your care for the sole purpose of promoting their services.
By completing this form, you agree that pictures or video of you or people you are responsible for, or/and any statements you give voluntarily, can be used to promote Kirikiriroa Family Services Trust's services.

I consent to being photographed or filmed by Kirikiriroa Family Services Trust. Write your name below. *

I give my consent to Kirikiriroa Family Services Trust to photograph or film the following child/children under the age of 18 years, legally in my care. Write their names below.

I understand photographs and/or film may be used by Kirikiriroa Family Services Trust for promotional purposes of any kind at any time in the future. Images may be cropped, altered, transformed or reproduced in any way and may be combined with other works or text. I release Kirikiriroa Family Services Trust from any claims and demands in connection with the photographs and/or film. Write your name below and today's date. *

Write your contact details (address, phone, email) *

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