Youth Services for Choctaw, Pushmataha and McCurtain Counties

Media Release:

I grant permission to Youth Services for Choctaw, Pushmataha, McCurtain Counties (YS4CPM) and Project G.A.I.N (PG) , its agents and assigns, to use my photo or video, and likeness for the purpose of promotion by YS4CPM and Project G.A.I.N for all forms, media and manners, for the following, but not limited to, news releases, photographs, video, audio, website, marketing, advertising, trade, promotion, exhibition for an indefinite period of time. I give unrestricted permission for images, videos, and recordings of myself to be used in print, video, digital and internet media. I agree that these images and/or voice recordings may be used for a variety of purposes and that these images may be used without further notifying me. I further acknowledge that I will not be compensated for these uses and YS4CPM and Project G.A.I.N owns all rights to the images, videos, and recordings, and to any derivative works created from them. I waive any right to inspect the uses of any printed or electronic copy. I hereby release YS4CPM and Project G.A.I.N and its agents and assigns from any claims that may arise from these uses, including without limitation claims of defamation or invasion of privacy, or of infringement of moral rights or rights of publicity or copyright. This release expresses the complete understanding of the parties.

Liability Release:

By signing this form, I hereby release YS4CPM and Project G.A.I.N, any affiliates, volunteers, and any other entity connected with the facilitation or representation of YS4CPM and Project G.A.I.N for any and all known or unknown damages, injuries, losses, and/or claims, that may be suffered by participant or his/her property during the participation of the said activity/program/event.