Cerebral Palsy Association of BC

Vancouver Island Awareness Project: Photo & Video Release


I,   , hereby

to have my name, photo and location released to

Cerebral Palsy Association of British Columbia, located in Vancouver, BC,

AND

Intercultural Strategies, located in Richmond, BC,

for marketing purposes.

  • Cerebral Palsy Association of BC
  • Intercultural Strategies

My information:

Phone:  
Email:  
City:
CPABC Member:
Are you participating in the Vancouver Island awareness project?:  


Parent / Guardian Name:


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

Leave this empty:

Signature arrow sign here


Signature Certificate
Document name: Vancouver Island Awareness Project: Photo & Video Release
lock iconUnique Document ID: 046c89d1bec47f78f643b8e06ea041be8d43a8bb
Timestamp Audit
September 27, 2020 10:47 am PSTVancouver Island Awareness Project: Photo & Video Release Uploaded by Denzil Muncherji - programs@bccerebralpalsy.com IP 23.16.75.213