Media/Photo Release Form


By signing this form, I give consent on behalf of my child(ren) or myself to Community Action Network to use my child(ren)'s and my name, photograph, portrait, and any likeness in any media form and type of publication, including newspaper articles, annual reports, newsletters, and social media.

I grant Community Action Network any and all rights to said use without compensation.




Include Apartment or Unit Number separated by a comma







You will be asked to submit an E-Signature on the following page.