PG365 Fundraiser Calendar

Name*

First Name, Last Name

Organization*

Organization Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number*

Please enter a valid phone number.Format: (000) 000-0000.

Email*

example@example.com

Social Platform for Sponsorship*

*

Username / Link / URL

Upload Business/Organization Logo*

Donation Amount

Other Donation (Amount Not Listed)

*

MonthlyYearlyOne Time

PG Board Members Name (if applicable):

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I am aware PG produces promotional material about their program. I understand that my logo, image, etc. may be included in video tape or photography taken during participation of programs, activities, and/or events. I hereby give unrestricted permission to PG, its successors, assignees, licensees, community partners/sponsors, any television networks, and all other commercial exhibitors the exclusive right to photograph and/or video tape myself, business or organization and further to utilize my myself, business or organization name, face, likeness, voice, and appearance as part of the event/program/activity, and in advertising and promotion of the event/program/activity, without reservation or limitation. 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 PG owns all rights to the images, videos, and recordings, and to any derivative works created from them. I waive the right to inspect the uses of any printed or electronic copy. I hereby release PG and its agents and assigns from any claims that may arise from these uses, including copyright. This release expresses the complete understanding of the parties. In granting this license, I understand that PG is under no obligation to exercise any of it rights, licenses and privileges herein granted.*

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