I have participated as indicated in the above Program.  In consideration of my participation in the Program, and without further consideration from the City of Surrey, its employees, or representatives, I hereby grant permission to the City of Surrey to utilize my likeness and biographical material about me in connection with the Program for publication in brochures, social media, websites and other promotional materials created by or on behalf of the City of Surrey.  The purpose of the promotional materials is to promote the diverse businesses, residents and cultural aspects of the City of Surrey.  I agree that my likeness, including any recording of it, may be used in conjunction with any other material, as the City of Surrey may in its sole discretion determine.  

I expressly release the City of Surrey, its affiliates, employees, and representatives, from and against any and all claims, demands, or causes of action which I may have for invasion of privacy, defamation, infringement of copyright or any other cause of action arising out of distribution, broadcast or exhibition of my likeness. This release shall be governed by the laws of British Columbia.  The courts of British Columbia shall have exclusive jurisdiction in the event of any dispute under this release.

Personal information is collected for the purposes outlined in this appearance release form. The City of Surrey is collecting personal information pursuant to Section 26(c) of the Freedom of Information and Protection of Privacy Act.  For questions regarding the collection, use and disclosure of personal information please contact the Manager of Marketing and Communications, 13450 - 104 Avenue Surrey, BC, V3T 1V8, Tel: 604 598-5785.

This release form is for an Adult or Youth (youth being aged 12 to 18 years old).