By submitting this form, your consent has been given to Social Planning Cowichan to publish any materials provided in the "Comment," and/or "Picture Upload," and/or "Video Upload" fields for the specific purposes of publishing documents and/or videos online and on social media, and distributing documents and/or playing videos at events, either as individual clips or as apart of a longer video. 

Your email and phone number will not be shared or published under any circumstances. Providing your email and/or phone number is explicit consent to be contacted by Social Planning Cowichan for purposes of publishing your materials should the need arise. 

Your name will not be shared or published unless you have chosen the response "No" in reply to the field "Would You Like to Remain Anonymous?"