Nonprofit Social Media Release Consent Form

I hereby grant permission to ______________________ (Nonprofit Organization) to use my image, likeness, name, written or spoken statements, and/or audio/video recordings on their social media channels and other promotional materials. I understand that my participation is voluntary and that these materials may be used in printed and electronic media.

Full Name Email Phone Address

I understand that I may withdraw my consent at any time by notifying the organization in writing. This will not affect any materials already published prior to my notice of withdrawal.

Parent/Guardian Name