I hereby authorize Child and Family Agency of Southeastern CT, Inc. to photograph and/or video me and/or my child(ren), and to use photographs, video recordings, and/or submitted media for purposes including marketing, fundraising, advocacy, public education, and increasing awareness of CFA programs.
By signing below, I certify that all information provided is accurate. I have read and understand this Registration & Consent Form, including Release of Information, Informed Consent (including Emergency Medical Consent), Media Release, and Behavior Agreement. I understand that failure to comply with program policies may result in dismissal.
This form remains in effect for the duration of enrollment unless revoked in writing.