Consent Of Media Release

Consent Of Media Release
Name of Releasor
Agreed and Accepted by
Name of Releasee

First NameLast Name
Email of Releasee
example@example.com
Phone Number of Releasee

Area CodePhone Number
Age of Releasee
Date

MonthDayYear
Date
Address of Releasee

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Media Release: By volunteering and or sharing information to Joy's Foundation, you consent to your voice or likeness being used without compensation in films, all media, videos, print, publications, and social media, whether known or hereafter devised. Your release to Joy's Foundation, media affiliates, and their successors assigns and licensees from any liability on account of such usage.
Attestation of Legal Age

I certify that I am of legal age and competent to contract in my own name. I have read this release before signing below and I fully understand the contents, terms, and the effect of this release.
Attestation of Parent/Guardian

I am the parent or legal guardian of the named minor in this agreement. I have read this release before signing below, and I fully understand the contents, terms, and the effect of this release.
Signature of Releasor or Releasor's Guardian

Clear
Should be Empty:

Agreed and Accepted by