Media Waiver

YFC Canada

YFC is a national organization built on local chapters.

Registered Charity #106868847RR0001

Registered Charity #132943721 RR 0001

Age of Majority*
- I am over the age of majority in my province/country and am signing for myself
- I am the parent/guardian of a minor in my care and signing on their behalf
*Age of Majority is 18 in AB, MB, ON, PE, QC, and SK and most countries, 19 in BC, NB, NL, NT, NS, NU, and YK
Participant Name*
Legal First Name Last Name
Participant Preferred Name
Preferred Name
Date of Birth*
MM slash DD slash YYYY
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email address for follow-up if required*
Where do you connect with YFC
- YFC Steinbach (Backstage)
- YFC Blumenort
Parent/Guardian Name*
First Last
Relation to the participant
Parent/Guardian Work Phone*
Parent/Guardian Email*
Consent*
I agree
I agree to permit reasonable use of photos, videos, written materials or other pictures of in promoting Youth for Christ | Youth Unlimited and their activities and programs. I understand that these could appear in agency newsletters, brochures, websites or social media in (present and future material); or in local newspapers, on television, and might identify participants by first name.

I hereby give permission to Youth for Christ | Youth Unlimited to use photographs or any other media representation of at the discretion of the agency.

I release Youth for Christ | Youth Unlimited, its officers, directors, volunteers, and staff from any and all responsibility/liability that may arise as a result of the use of such photos/media.

BY giving permission to Youth for Christ | Youth Unlimited, we will NOT sell or distribute your photo to an outside agency or organization, and the material we create will be used for Youth for Christ | Youth Unlimited’s sole purpose.

I certify that as of today I am above the provincial age of majority.
Signature*