Boorn Media Release form

I give consent to BOORN to use and retain the image/ video attached for advertising purposes including, BOORN’s website, social media (Facebook, Instagram, Twitter) and printed advertising material.

I understand that I may withdraw this consent at any time by advising BOORN and my photo/video will be removed or destroyed at this time.

I understand that by giving consent, BOORN can use the image/recordings to promote their activities. BOORN may reproduce the image or video in any form, in whole or part and distribute by any medium including printed material, internet or multimedia.

I understand that BOORN:

Will not pay me for giving consent or for the use of this image or recording
Will return or destroy images or recordings if I withdraw my consent

Media Release Consent *

I give consentI DO NOT give consent

Participant's Name *

Nominee (Guardian)'s Name

Email Address

Signature *

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Date

I understand that to maintain safety of participants, clients, customers and staff there are sercurity cameras within the Boorn buildings. These security cameras collect visual and audio recordings that are stored and disposed of as per security guidelines. This footage is not used for any other purpose, other than maintaining safety and security. *