Photo and Video Release Form
Name of person completing this form
*
First Name
Last Name
Are you completing this form for someone under the age of 18?
*
Yes
No
Name of person under the age of 18
First Name
Last Name
How are you related to the volunteer?
Email
*
example@example.com
Authorization, Release, and Consent
Can we use your name?
*
Yes, you may use my Full Name.
Yes, but my First Name only.
No, you may not use my name.
Photo/Video Release Acknowledgement
*
I authorize and grant {REACH and it's partners} to take/use my photos/videos regarding my experiences with them.
I grant REACH and it's partners to use my photos on Facebook, Twitter, Instagram, and other social media platforms to highlight their mission or promote upcoming opportunities.
I allow REACH and it's partners to edit, alter, copy, or distribute the photos/videos for social media advertising, programming and marketing.
I agree that the photos belong to {REACH and it's partners}.
I understand that I will not receive any monetary compensation.
Signature
*
Date Signed
*
-
Month
-
Day
Year
Date
Submit
Print Form
Should be Empty: