I, {name}, authorize that my personal experiences video and/or image, may be used in connection with publicizing and promoting the Indigenous Youth COVID-19 Vaccine Uptake Working Group, in partnership with various Indigenous partners, and their #MyVaxxJourney campaign, to inform and engage Indigenous Youth of COVID-19, COVID-19 vaccines, and increasing vaccine confidence and public health safety.
With the exception of any personal information that is subject to applicable privacy laws in Canada, I understand that my experiences shared in video and/or image will provide as a testimonial, in support of the Indigenous Youth COVID-19 Vaccine Uptake Working Group and their #MyVaxxJourney campaign. I hereby authorize the Indigenous Youth COVID-19 Vaccine Uptake Working Group to copy, exhibit, publish or distribute my first name and first last name initial, social media handle(s), comments or testimonial, and image or other likeness, whether on video tape or via photograph, for the administration of the Contest, for the purposes of publicizing the #MyVaxxJourney campaign, or for any other lawful purpose directly relating to the campaign or Contest in printed publications, associated social media platforms, multimedia presentations, on an associated website, or in any other distribution media (video, and/or ads), without further notice or compensation.
I hereby hold harmless and release the NAFC and the Indigenous Youth COVID-19 Vaccine Uptake Working Group per the Contest Terms and Conditions from all claims, demands and causes of action which I, my heirs, representatives, executors, administrators or any other persons acting on my behalf, or on behalf of my estate, have or may have by reason of this authorization.
By signing this Consent Form, I have authorized that I have read this form and the Contest Terms and Conditions carefully and fully understand their meanings and implications, and give my consent for the use as indicated above and in the Contest Terms and Conditions.