Share your heartfelt thanks

Your image, voice, comment, testimonial and/or other information (the “Materials”) was recently recorded by or for Fraser Health Authority (“Fraser Health”). You have been asked to review and sign this form in order to provide your consent for Fraser Health and/or external media outlets/third parties to use the Materials. You understand that your consent is voluntary and you are under no obligation to sign this consent form.

By signing this consent form you irrevocably consent to the use of the Materials throughout the world by Fraser Health in its sole discretion and/or by external media outlets/third parties and without compensation to you. “Use” in this consent form means: i) unlimited disclosure of the Materials for internal or external non-commercial use in all forms, media and technologies now known or hereafter developed, including via the Internet and social media channels; and ii) the right to change or modify the Materials, and to use the Materials alone or to combine them with any other materials. You agree that Fraser Health owns all rights to the Materials and that it may, but is not obligated to, disclose your name in connection with its use of the Materials.

You confirm that you waive any rights you may have with respect to the Materials, including any moral rights or any right to inspect or approve the Materials or the context in which Fraser Health uses them. You agree that Fraser Health and its representatives will not be liable to you for their use of the Materials.

You confirm that you have read and understood this consent form, that you are at least 19 years of age and that you are entitled to enter into this consent form. In the event that any of the Materials include the image, voice or other personal information of a minor under 19 years of age, you confirm that you are the parent or legal guardian of that minor and that you have the authority to, and do, consent and agree on behalf of them. In that case, any references in this consent form to “you” or “your” will be read as references to you on behalf of the minor.

Your personal information is being collected under Section 26 of the Freedom of Information and Protection of Privacy Act for the purposes described in the consent form above. If you have any questions regarding the collection of your personal information under this consent form, please contact Fraser Health’s Information Privacy Department at: informationprivacy@fraserhealth.ca.