Cerebral Palsy Association of BC

Photo and Video Release


I,  , hereby

to have my name, photo and location released to Cerebral Palsy Association of British Columbia for marketing purposes.

My information:

Phone:  
Email:  
City:  
CPABC Member:
CPABC Programs/Events participation:  

Parent / Guardian Name:

By signing below, I certify all information is true and correct to the best of my knowledge.

Leave this empty:

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Signature Certificate
Document name: Photo and Video Release
lock iconUnique Document ID: 1d2e83261a7ebb182d2a78ebdd88c582174e7e04
Timestamp Audit
May 4, 2020 9:33 pm PSTPhoto and Video Release Uploaded by Denzil Muncherji - info@bccerebralpalsy.com IP 23.16.205.224
August 9, 2024 11:21 am PSTAdmin Assistant - info@bccerebralpalsy.com added by Denzil Muncherji - info@bccerebralpalsy.com as a CC'd Recipient Ip: 23.16.205.224
August 9, 2024 11:21 am PSTTiffany Test - tiffany@tiffanymark.com added by Denzil Muncherji - info@bccerebralpalsy.com as a CC'd Recipient Ip: 23.16.205.224
August 9, 2024 11:48 am PSTAdmin Assistant - info@bccerebralpalsy.com added by Denzil Muncherji - info@bccerebralpalsy.com as a CC'd Recipient Ip: 23.16.205.224
August 9, 2024 11:48 am PSTTiffany Test - tiffany@tiffanymark.com added by Denzil Muncherji - info@bccerebralpalsy.com as a CC'd Recipient Ip: 23.16.205.224
August 9, 2024 12:37 pm PSTAdmin Assistant - info@bccerebralpalsy.com added by Denzil Muncherji - info@bccerebralpalsy.com as a CC'd Recipient Ip: 23.16.205.224
August 12, 2024 3:11 pm PSTAdmin Assistant - info@bccerebralpalsy.com added by Denzil Muncherji - info@bccerebralpalsy.com as a CC'd Recipient Ip: 23.16.205.224
Audit trial Qr code
This audit trail report provides a detailed record of the online activity and events recorded for this document.
https://bccerebralpalsy.com/
Audit Trail Serial# 646340298cdecd215aadcffb7de50395