Photo Waiver Release Form

1

I hereby grant the release permission to use photographs and Videos in any of the following:

2

Release of Photographs in

Web-based publications

Print Advertisements

Organization Bulletin

3

I hereby affirm that such release to the releasee does not constitute any form of compensation, including royalties arising from the photographs, to my benefit. I understand and agree that photographs in the possession of the releasee shall become the property of the releasee. The use and publication of the photographs however, shall conform to my rights as a subject of said photographs. I hereby waive my right to inspect of approve the photographs by which my likeness appears. I hereby hold harmless, release, and forever discharge the {Name of Organization} from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or on behalf of my estate have or may have by reason of this authorization.

4

Age of Consent

I am of legal age

I am a minor and represented by my parent/guardian

5

I declare true my age of consent, and in case I am under the age of such consenting age, I have obtained the required consent from my parents/guardians as evidenced by the signatures below:

6

Name of Person Subject of Photograph

7

Signature

Clear

8

Name of Parent/Guardian of Person Subject of Photograph

9

Signature of Parent/Guardian

Clear

10

Date SIgned

Date