Appearance and Submitted Media Release Form

"*" indicates required fields

Joni and Friends Office*

Legal Name*

First Last

Title (if relevant)

Name as it should appear on screen on in print

First Last

Is the on-camera participant is a minor?*

Yes

Parent or Guardian Name*

If the on-camera participant is a minor, parental or guardian consent is required.

First Last

Secured by reCAPTCHA