Youth Media Release

I give permission for Washington School-Based Health Alliance (WA SBHA) and partners to share/display photos/videos of [myself if 18 or over / my minor child]. I also give permission for Washington School-Based Health Alliance and partners to use these photos/videos in the following ways: social media (examples: Facebook, Twitter, Instagram), websites (examples: WA SBHA website, partner websites, blogs), promotional materials (examples: flyers, postcards, informational brochures), media (examples: magazines, newspapers, online sources, television), other ways as needed. I understand that if I sign this permission form, these photos and videos may be shown to communicate about Washington School-Based Health Alliance and related programs. I understand that Washington School-Based Health Alliance may continue to use and show photos and videos of myself/my child in the way described above, even after the Student Health Summit 2023 event.  I may cancel this consent by writing to Washington School-Based Health Alliance. Washington School-Based Health Alliance will not use or show the photos or videos after receiving my cancellation. However, Washington School-Based Health Alliance cannot control others who may still use and/or show the photos or videos. I understand that I have the right to decline this consent form. I understand that I am volunteering this material free of charge. I am voluntarily choosing to be a part of this program, and my signed copy of this form is available upon request.