Media Consent form

Media consent: Required for each home via email or in-person signature.

While we value your privacy, our contributors seek to witness the impact they're creating in the community. Assist us in demonstrating our efforts in restoring communities.

I grant permission to You Don't Know My Story, Inc, hereinafter known as the “Media” to use my image (photographs and/or video) for use in Media publications including: ❏- Videos ❏- Email Blasts ❏- Recruiting Brochures ❏- Newsletters ❏- Magazines ❏- General Publications ❏- Website and/or Affiliates ❏- Other: ________________

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