PHOTO CONSENT FORM

    1. Permission to photograph or record

    I, permit AIDS Healthcare Foundation (“AHF”) to:

    take photographs of me in any media.record videos of me in any media.record the sound of my voice in any media.
    at

    on .

    I agree that AHF may keep the photographs or recordings above (individually or together, the “Media”) indefinitely.

    2. Authorization to use/disclose

    I further authorize AHF to use and/or disclose the Media in media galleries, websites, printed materials, online, social media, business operations, publicity, advocacy, marketing, advertising, or fundraising.

    I understand that I may revoke this document at any time by sending a written notification to AHF at:
    AHF Marketing
    6660 Santa Monica Blvd, Floor 2
    Los Angeles, CA 90048

    However, I also understand that my revocation will not affect any actions that AHF takes with the Media before the receipt of the written revocation.


    PHOTO/VIDEO CONSENT FORM


    1. Permission to photograph or record

    I, permit AIDS Healthcare Foundation (“AHF”) to:

    at

    on .

    I agree that AHF may keep the photographs or recordings above (individually or together, the “Media”) indefinitely.

    2. Authorization to use/disclose

    I further authorize AHF to use and/or disclose the Media in media galleries, websites, printed materials, online, social media, business operations, publicity, advocacy, marketing, advertising, or fundraising.

    I understand that I may revoke this document at any time by sending a written notification to AHF at:

    AHF Marketing
    6660 Santa Monica Blvd, Floor 2
    Los Angeles, CA 90048

    However, I also understand that my revocation will not affect any actions that AHF takes with the Media before the receipt of the written revocation.

    Leave this empty:

    Signature arrow
    Signature Certificate
    Document name: PHOTO/VIDEO CONSENT FORM
    lock iconUnique Document ID: 8afcd74ec1ad1972f4446a9627650abb9fb56587
    Timestamp Audit
    August 7, 2018 12:37 pm PDTPHOTO/VIDEO CONSENT FORM Uploaded by Kevin Pakdivichit - [email protected] IP 12.208.247.130