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That applies to you): A VIHA physician A Crothall employee A VIHA employee Other: A VIHA volunteer Family member of (please give A VIHA Auxiliary member name and job position): A Morrison employee Home address & Contact information: Street number and name: City: Province: Postal Code: Telephone number: Email Address: Title of submitted photograph: Short description of event or activity depicted: ( ) - . 2 Photo Release Form: I agree to the following terms and conditions: The photo that I.

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