Media Consent Form – Child | Give Until It Hurts

I, Parent/Guardian Name *

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Last

Parent/Guardian of: *

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Last

Electronic Declaration *

I give permission

for my child's photographs or videos taken as part of the GUIH daily program, to be used now or in the future for the purpose of external communications, including advertising and marketing as well as posted on the GUIH Social MEdia account(s) including Facebook, Instagram, Twitter and business website.

I understand I can withdraw the above permission at any time by advising GUIH in writing via email to info@guih.org.

Parent/Guardian Name *

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Last

Child's Name *

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Last

Home Address *