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I hereby grant permission to The Corporation of the City of Kitchener ("the City of Kitchener") to use photographs or videos of me and/or my child(ren).
in print and electronic media without further considerations. Such photographs or videos may be used by the City of Kitchener in a variety of mediums, including but not limited to newsletter, brochures, website and in submissions to the local papers for publicity purposes.
I understand that once my photograph or video is posted on a website, the image can be downloaded by any computer user.
I acknowledge the City of Kitchener's right to crop or edit the photograph or video at its discretion. I also acknowledge that the City of Kitchener may choose not to use my photograph or video at this time, but may do so at its discretion at a later date.
The City of Kitchener reserves the right to use or discontinue use of my photograph or video without notice.
Person(s) signing this form must be 18 years of age or parent or legal guardian.
This section is to be completed by the person granting consent.
Personal information is being collected under the authority of Municipal Act, s. 11. and will be used to retain a record of the permission to use a photo and/or video in City of Kitchener marketing and communications projects. This information will be shared with staff who require it for their work as part of records retention and will be stored on a server owned by a Third Party Service Provider (GHD Digital) located in Canada. The personal information collected herein will be used only for the purposes relating to the program and will be protected in accordance with the requirements stipulated in the Municipal Freedom of Information and Protection of Privacy Act.
Inquiries about the collection, use or disclosure of your personal information should be directed to Nicole Amaral (nicole.amaral@kitchener.ca), manager of digital media and creative services.
This section is to be completed by the staff person taking the photo or video.
