Spinal Cord Injury Ontario

Media Release Form

    SCIO Media & Story Release Form

    The undersigned does hereby authorize permission for Spinal Cord Injury Ontario to use and display the reprint of articles I write, in full or in part, including still photographs, videos and any biographical information that I provide including the use of my name for use in Community magazine, and in any Spinal Cord Injury Ontario approved publication, multimedia production, display, advertisement or website publication for Spinal Cord Injury Ontario or its constituent departments.

    The undersigned releases and forever discharges Spinal Cord Injury Ontario, its agents, officers and employees from any and all claims and demands arising out of or in connection with the use of said written material, photographs, including but not limited to, any claims for invasion of privacy or defamation.

    I accept and agree to the above terms:

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