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©Prince’s Trust Canada 2019 – all rights reserved. Prince’s Trust Canada is a registered Canadian charity - registration number – 832295406RR0001 Registered office: Prince’s Trust Canada, 1255 Bay St., Toronto, ON M5R 2A9 How will your photo, video or written case study be used? In printed marketing materials (e.g. a leaflet to promote Prince’s Trust Canada) On the Prince’s Trust Canada website or social media sites In the media (e.g. to promote Prince’s Trust Canada in a newspaper or on TV) In our printed or online advertising In any marketing materials promoting Prince’s Trust Canada or The Prince's Trust Group By other organizations that work with Prince’s Trust Canada (e.g. funders, employer partners, community organizations) Please note: if your case study and/or photo is going to be used as an individual story in a public facing medium, such as the press or a Prince’s Trust Canada publication, you will be contacted to ensure you are happy for it to be used in this way. However once your photograph or story has been used, we’re no longer able to control if it is used again by the same newspaper or potentially elsewhere. Your photo/story will be used for up to three years, unless you ask us to stop using it. PLEASE TICK TO GIVE YOUR CONSENT I understand my right to ask to see any information held about me by Prince’s Trust Canada. I also understand that while Prince’s Trust Canada makes every effort to ensure all media coverage is positive, it does not have final control over how a journalist may portray me. Prince’s Trust Canada will only pass your individual information on to third parties with your consent or where we are required to do so by law. You can write to us if you would like to see any information which we hold about you. We will provide this information in line with the Personal Information Protection and Electronic Documents Act (Canada). OVER 18 Name:.................................................................................................................................................... Phone No. : ......................................................................... Email: ................................................................................. Signed: ............................................................................................................................ Date (Y/M/D): .................................. UNDER 18 (consent is required from a parent or guardian) Parent/guardian name: .................................................................................................................................................... Name of young person:.................................................................................................................................................... Parent/guardian signature: .............................................................................................. Date (Y/M/D): ................................ PRINCE'S TRUST CANADA PUBLICITY CONSENT FORM Used in order to gain consent for photography, film and written case studies For internal use Program: City: Date (Y/M/D): 1. Verbally explain this form to the person signing it 2. If consent is for a written case study, please attach it to this form 3. Send a copy of this form, with a copy of the case study/film/photographs to: “Prince’s Trust Canada, 1255 Bay St., Toronto, ON M5R 2A9” IF YOU DO NOT GIVE CONSENT, PLEASE TICK HERE For Prince's Trust Canada staff, please:
