COVID-19 Contact Tracing is now underway at all City of Palmerston facilities. READ MOREThe City of Palmerston encourages residents to keep up-to-date with the latest information from SecureNT.

 Local Government Elections 2021. MORE INFO.

Release Form for Media Recording

I, the undersigned, do hereby consent and agree that the City of Palmerston, its employees, or agents have the right to take photographs, videotape, or digital recordings of myself, or my child, or dependant to use these in any and all media, now or hereafter known, and exclusively for the purpose of promoting the City of Palmerston.

I do hereby release to the City of Palmerston, its agents, and employees all rights to exhibit this work in print and electronic form publicly or privately and to market and sell copies. I waive any rights, claims, or interest I may have to control the use of my identity or likeness in whatever media used.

I understand that there will be no financial or other remuneration for recording me, either for initial or subsequent transmission or playback.

I also understand that the City of Palmerston is not responsible for any expense or liability incurred as a result of my participation in this recording, including medical expenses due to any sickness or injury incurred as a result.

I represent that I am at least 18 years of age, have read and understand the foregoing statement, and am competent to execute this agreement.

Contact Details
My Signature
Sign above