Please fill out this form to provide your consent for the use of your information, image, or participation in company activities.
Please indicate your consent for the following (check all that apply)
Use of my image and likeness in company materials (e.g., brochures, website)
Participation in company events or activities
Use of my feedback or testimonials in company promotions
Please specify the purpose for which this consent is being granted
I understand that my consent allows [Your Company Name] to use my information and image as indicated above. I acknowledge that I can withdraw my consent at any time by notifying the company in writing.
Name:
Date:
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