Cerebral Palsy Association of BC

Photo and Video Release


I,  , hereby

to have my name, photo and location released to Cerebral Palsy Association of British Columbia for marketing purposes.


My information:

Phone:  
Email:  
City:  
CPABC Member:
CPABC Programs/Events participation:  


Parent / Guardian Name:


By signing below, I certify all information is true and correct to the best of my knowledge.

Leave this empty:

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Signature Certificate
Document name: Photo and Video Release
lock iconUnique Document ID: aaf9eebe19dba62ab99fa0f5a4a4eac6a00af45b
Timestamp Audit
May 4, 2020 9:33 pm PSTPhoto and Video Release Uploaded by Denzil Muncherji - info@bccerebralpalsy.com IP 23.16.75.213