Recording Release Opt-Out

Recording Release Opt-Out

2023 HAVI Conference
Conference photographers and videographers will be capturing participant activity at all scheduled events during the 2023 HAVI Conference. Please complete and submit this form ONLY if you do NOT wish for your likeness to be shared or released.
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
I, the undersigned, do not wish the HAVI staff to record my participation and appearance on any recorded medium including, but not limited to video, audio, photos (collectively, “recordings”) for use in any form (including, but not limited to print, websites, blogs, internet). I understand the HAVI will make reasonable efforts to comply with my request. If I become aware of a recording with my likeness, I will notify the HAVI through the website's HAVI Contact Form. I understand that the HAVI will then make reasonable efforts to remove my likeness from recordings.

I also hereby confirm that I am of legal age (18) and have every right to contract in my own name as stated above.
Signature*

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