Client Publicity and Media Release Form

DRNC Client Publicity and Media Release Form

This is a digital version of the standard consent form used by Disability Rights North Carolina (DRNC).

Thank you for helping DRNC share information about the stories and people involved in our legal advocacy work. The information, pictures, and videos you provide are often used to highlight the work we do and the issues related to disability rights.

Please take a moment to complete this publicity release form. By doing so, you will be giving DRNC permission to use your image, quotes, name, and general information, unless you tell us otherwise.

If you would like to speak to someone to explain anything on this form, please reach out to your DRNC attorney or advocate, or email  to speak to the someone on DRNC’s communications team.

Full Name(Required)
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I prefer to be contacted by: (check all that apply)(Required)
DRNC has my permission to: (check all that apply)(Required)


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