Photo Release Form

Photo Release Form

Partipant Name

First NameLast Name

Screen Free Kids LLC has my permission to use my photograph, and those of all members of my party, publicly for promotional materials. I authorize Screen Free Kids LLC to edit, change, copy, and make any use of all photographs of me and my party to be used for promotional materials. I understand that the images may be used in print brochure, website, and social media. I also understand that no royalty, fee or other compensation shall become payable to me by reason of such use. Upon the usage of my photographs, I consent to such materials becoming the sole property of Screen Free Kids LLC and that I will no longer be entitled to them, provided that it is done for lawful purposes. I hereby release all rights to any but not limited to claims, rights, demands, and/or any causes of action by me or my representatives, heirs, or anyone else.

I, the undersigned participant, affirm that I am of the age of 18 years or older, and that I am freely signing this agreement. I certify that I have read this agreement, that I fully understand its content and that this release cannot be modified orally. I am aware that this is a photo release form and a contract and that I am signing it of my own free will.

Name

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Signature

Date

Parent/Guardian Name

First NameLast Name

Parent/Guardian Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Parent/Guardian Signature

Date

Please list all party members: