Credit Union: Synergy Credit Union
Address: PO Box 798 STN MAIN Lloydminster, SK S9V 1C1
Phone: 1-866-825-3301
I declare that the photograph(s) submitted is (are) an original work of my own creation. If my photograph includes people, including minors, I confirm that I have the permission of the individuals present in the photograph, or their legal guardian if a minor, to share their image.

I agree to grant Synergy Credit Union (Synergy) use of any photos submitted without remuneration for Synergy’s website, digital banking application, social media accounts, print materials, advertising, in branch use or posters. By submitting my entry, I give my consent for my name, photograph, and photograph description to be publicly shared.

In giving this consent, I release Synergy Credit Union, their nominees and designees from any and all liability for any violation of any personal or proprietary right I may have in connection with such sale, reproduction or use. I certify that I am of legal age and consent and have the legal authority to execute the above consent and release. I approve the foregoing and waive any rights in the premises.

I understand that this consent is in addition to, and not in substitution for, any other consent, express or implied, which I have given Synergy Credit Union to collect, use and disclose my personal information. This consent may be withdrawn by contacting Synergy Credit Union using the information above.

If I withdraw consent, I acknowledge that existing publications will not be withdrawn from circulation.

Personal information held by Synergy Credit Union will be retained and destroyed in accordance with Synergy Credit Union’s retention of records policies and privacy legislation.

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* Check the box below to agree or disagree to the terms and conditions above

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* Your Information

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* Your relationship with Synergy:

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* Photo file name(s), your name and location submitted/to submit

Please ensure your photo meets the following requirements:

• Image is local (within 100 km of a Synergy Branch)
• File format is .png or .jpeg
• Submit your highest quality images (max combined file size is 5GB)
• Photos cannot be screenshots
• Ensure that your photo is not cropped and does not contain borders or watermarks
• Please ensure photo file name matches file name on this submission form

PLEASE NOTE, if your photo file name is not clearly identified on the consent and submission form, we are not able to use your photo as we will not have a way to cross-reference your consent to your photo.