Media Consent Form

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Media Consent Form

Consent To Release Information Through All Forms of Media Including, But Not Limited to: Interviews, Print Media, Photographs, Motion Picture, Video Production, Radio & Television, and Social Media 

Any questions about this consent form may be directed to the Communications/Marketing Department at Centra, 1920 Atherholt Road, Lynchburg, VA 24501 • 434.200.4730.