Media Interview Consent Form
Please read the form carefully, complete the required fields.
Participant Information
Consent Agreement
I, [Your Name], hereby grant permission to [Your Company Name] to record, photograph, and/or interview me for media purposes. I understand that my statements, likeness, and recordings may be used in promotional materials, social media, websites, or other media platforms associated with [Your Company Name].
I confirm that I am voluntarily participating and understand that I will not receive compensation for the use of these materials. I may withdraw my consent at any time by notifying [Your Company Name] in writing.
Name:
Date:
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