Parents of Multiple

Births Association – Halifax

Photo Release Form

Permission to Use Photographs


  • I grant POMBA and its volunteers the right to take photographs of me and my family members at all POMBA Events.
  • I authorize POMBA, its assigns and transferees to copyright, use and publish the same in print and/or electronically.
  • I agree that POMBA may use such photographs of me and my family with or without my name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and Web content.
  • I have read and understand the above:


Signature _________________________________

Printed name ______________________________

Date _____________________________________ 


If you choose not to sign the Photo Release Waiver Form,
it is the member’s sole responsibility to notify any photographer at events
that you do not give your permission to have you and your family members’ photo taken.