• I,*
  Full name (First, Middle, Last)
• hereby grant the B.C. Aboriginal Network on Disability Society (BCANDS) the right and permission to use and publish photographs or video images of me, or in which I may be included, for the purpose of Society website use, editorial publications and promotional use, including personal information and statements relating only to my Aboriginal affiliation, name and the quality of services that I have received from the Society, unless further authorized by me. I understand that the circulation of such materials could be worldwide and there will be no compensation to me for this use. In granting this permission to the Society, I am fully and without limitation releasing it from any liability that may arise from the use of the images. I understand that I may, at any time and at my discretion, instruct the Society in writing, to cease and discontinue the use of my image. *
  • I agree
• Signature*
  Please write your full name above, which will act as a digital signature.
• Witness Signature:
  Please write your full name above, which will act as a digital signature.
• Date