Media Release Form

Media Release Form

VET360 AND VETERAN EXPERIENCE LIBRARY (VEL)
Date

Month Day Year
Date
Name of Releasor

First Name Last Name
Email of Releasor
example@example.com
Phone Number of Releasor

Area Code Phone Number
Age of Releasor
Address of Releasor

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
The Media obtained shall be used for all of the following Veterans Services Commission Inc platforms

VET360TV Video Use Email blasts Newsletters Brochures or Flyers Magazines VSC Related Websites

CONFORME

I, {nameOf9} (hereinafter referred to as "Releasor"), grants permission to {nameOf} (hereinafter referred to as "Releasee"), to use my media (photograph image and/or video footage and/or audio recordings).

I likewise understand that I may be identifiable from the reproduction of the media by the Releasee indicated herein this agreement.

I hereby waive my rights to inspect or approve the media for production that may be used by the Releasee for purposes stated herein, from hereon forward.

I likewise waive any right to royalties or any compensation arising from or related to the use of the image.
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