Statement of Support
Type of Endorsement
Name of Individual / Org, as you would like it to appear publicly
Upload Organization Logo, if applicable (only for file types: .jpg, .jpeg, .png)
I/we are endorsing Issue 10 because…
Any statements in my video footage are based on my knowledge and are accurate and true to the best of my knowledge. I give my permission to the Committee to Improve Police-Community Relations and its partner organizations to use my name, photo/likeness, and any statements in my video for any and all video, print, digital, and web-based materials. I also voluntarily release and discharge the Committee to Improve Police Community Relations, its officers, employees, licensees, partner organizations, and affiliates from any obligation or liability of any kind or nature whatsoever, in connection with the use of my photo/likeness and its reproduction.
Electronic Signature (full name)