Permission for Release of Name and Image for Media Publication
I hereby grant the display of a photograph of my son/daughter/ward and the release of her/his name for media publication in regards to the Ontario CEC Annual Provincial Special Education Conference (listed below).
*** If 18+ and capable of giving consent, award recipient may sign for self.
Please complete and return this release, along with a black and white photo (jpeg) of yourself to donna.zuccato@gmail.com
Donna Zuccato
President and Co-Chair Awards
donna.zuccato@gmail.com