Please support us by linking your Kroger Plus card to Mountain Mentors. When you shop Kroger donates a percent of your purchases to us. This in no way affects the discount you receive or the cost of your purchase. Basically its a win-win. All you have to do is enroll your card through an email address. Click here for instructions.
Photo Consent
Embedded Scribd iPaper - Requires Javascript and Flash Player
Mountain Mentors / Camp Mills
A community outreach program for youth
1910 East Broadway, Northwood, OH 43619
419-481-3606
PHOTO/VIDEO/IMAGING CONSENT FORM Participant¶s Name: ___________________________________________ Check: Mentor____Student____Parent____Community Volunteer____ Address:______________________________________________________ Phone:___________________ Email: ______________________________ I hereby give my consent for photographing, videotaping, filming, or other recording during the activities of the Mountain Mentors program, without compensation or liability, to be used for the following purposes: Mountain Mentors or Northwest Ohio Community Shares Marketing or Publicity Purposes Mountain Mentors Newsletters Mountain Mentors Website Interviews with News Media Educational Purposes Other (specify) ______________________________________ ______________________________________________________
Signature of Adult Participant or Minor¶s Parent/Legal Representative
www.toledomountainmentors.org
Mountain Mentors / Camp Mills
A community outreach program for youth
1910 East Broadway, Northwood, OH 43619
419-481-3606
PHOTO/VIDEO/IMAGING CONSENT FORM Participant¶s Name: ___________________________________________ Check: Mentor____Student____Parent____Community Volunteer____ Address:______________________________________________________ Phone:___________________ Email: ______________________________ I hereby give my consent for photographing, videotaping, filming, or other recording during the activities of the Mountain Mentors program, without compensation or liability, to be used for the following purposes: Mountain Mentors or Northwest Ohio Community Shares Marketing or Publicity Purposes Mountain Mentors Newsletters Mountain Mentors Website Interviews with News Media Educational Purposes Other (specify) ______________________________________ ______________________________________________________
Signature of Adult Participant or Minor¶s Parent/Legal Representative
www.toledomountainmentors.org
This document has been released into the public domain.
| Attachment | Size |
|---|---|
| Mountain Mentors Photo Consent.docx | 54.74 KB |
