Charity Gala Filming Consent Form
Please complete this form to provide your filming and photography consent for the charity gala event.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Will you be attending the charity gala event?
*
Yes
No
Names of accompanying minors or guests (if applicable)
Scope of Permission for Use of Recorded Content
*
Event promotional materials (print, web, social media)
Charity’s website and newsletters
Media coverage (press, TV, online publications)
Internal archival purposes
Other
Signature
*
Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit Consent
Submit Consent
Should be Empty: