VIDEO CONSENT FORM

I, ____________________________,
(Full Name of Participant) hereby grant permission to NFJPIA Western Mindanao
Council to use my image, likeness, and voice in video recordings for social media promotion
materials.

I understand and agree to the following terms:

1. The recordings may be edited, copied, exhibited, published, or distributed by the NFJPIA
Western Mindanao Council.

2. The recordings may be used in perpetuity.

3. I waive any rights to inspect or approve the finished product or its use.

4. I understand that once the recordings are in circulation, NFJPIA Western Mindanao
Council may not be able to control their usage by third parties.

5. I release and discharge NFJPIA Western Mindanao Council from any claims or demands
arising out of the use of the recordings, including but not limited to claims for defamation,
invasion of privacy, or infringement of moral rights, rights of publicity, or copyright.

6. I confirm that I am over the age of eighteen (18) and have the right to enter into this
agreement. If I am under the age of eighteen (18), my parent or legal guardian has
reviewed and agreed to the terms stated herein on my behalf.

Signature Here
______________________________
Participant’s Full Name and Signature
Signature Here
_______________________________
Parent/Guardian’s Name and Signature
(If participant is under the legal age)

Date
_______________________
Date