Get Media Consent Form

Multi-media Permission Form Consent to Photograph Film Videotape Interview Audiotape videotape make an audiotape of film and/or interview either myself or the child/children named below and to publish said photographs videotapes audiotapes films and/or interviews in City of Toronto publications/material including marketing and promotional materials and the City of Toronto official Web site for current and future use. The photographs including negatives videotapes etc* shall constitute the exclusive property of the City of Toronto and may be reproduced by the City and anyone it has authorized without compensation or payment to the individual s concerned or any other person* Name First Last of Individual/Parent/Guardian Please print Address Telephone Number Signature of Individual/Parent/Guardian Today s Date yyyy/mm/dd Child/Children s Name First Last The personal information on this form together with the corresponding photographs/videotapes/audiotapes/films/interviews is collected under the authority of the City of Toronto Act S*O. 2006 Schedule A Chapter 11 s. 136 c and the Toronto Municipal Code Chapter 169 Officials City Article X. materials awareness training and the City of Toronto official Web site. Questions about this collection may be directed to the Media Services Supervisor Corporate Communications Toronto City Hall 100 Queen Street West 7 th Floor West Tower Toronto Ontario M5H 2N2 416 392-8937. The photographs including negatives videotapes etc* shall constitute the exclusive property of the City of Toronto and may be reproduced by the City and anyone it has authorized without compensation or payment to the individual s concerned or any other person* Name First Last of Individual/Parent/Guardian Please print Address Telephone Number Signature of Individual/Parent/Guardian Today s Date yyyy/mm/dd Child/Children s Name First Last The personal information on this form together with the corresponding photographs/videotapes/audiotapes/films/interviews is collected under the authority of the City of Toronto Act S*O. 2006 Schedule A Chapter 11 s. 136 c and the Toronto Municipal Code Chapter 169 Officials City Article X. 2006 Schedule A Chapter 11 s. 136 c and the Toronto Municipal Code Chapter 169 Officials City Article X. materials awareness training and the City of Toronto official Web site. Questions about this collection may be directed to the Media Services Supervisor Corporate Communications Toronto City Hall 100 Queen Street West 7 th Floor West Tower Toronto Ontario M5H 2N2 416 392-8937. The photographs including negatives videotapes etc* shall constitute the exclusive property of the City of Toronto and may be reproduced by the City and anyone it has authorized without compensation or payment to the individual s concerned or any other person* Name First Last of Individual/Parent/Guardian Please print Address Telephone Number Signature of Individual/Parent/Guardian Today s Date yyyy/mm/dd Child/Children s Name First Last The personal information on this form together with the corresponding photographs/videotapes/audiotapes/films/interviews is collected under the authority of the City of Toronto Act S*O. 2006 Schedule A Chapter 11 s. 136 c and the Toronto Municipal Code Chapter 169 Officials City Article X. materials awareness training and the City of Toronto official Web site. Questions about this collection may be directed to the Media Services Supervisor Corporate Communications Toronto City Hall 100 Queen Street West 7 th Floor West Tower Toronto Ontario M5H 2N2 416 392-8937.