Allies, Inc. Photo Release Form Permission to Use Photographs and Videos.

We are grateful for your support and participation in our programs, events, and activities. By signing this form, you grant Allies, Inc. permission to use your image, likeness, or voice in photographs, videos, and other media for promotional, educational, or fundraising purposes. This helps us share the impact of our work and engage more supporters to advance our mission.

Terms of Agreement

I, the undersigned, hereby authorize Allies, Inc. to:

1. Record my image and/or voice through photography, video, or audio recordings during events or activities hosted by the agency.

2. Use these photographs, videos, or recordings for purposes including but not limited to social media, printed publications, website content, and other marketing or informational materials.

3. Edit, alter, copy, or distribute these materials without requiring additional approval from me.

I understand that:

These materials may include information that could identify me as a recipient of services from Allies, Inc. and may be considered a disclosure of protected health information (PHI) under the Health Insurance Portability and Accountability Act (HIPAA).

These materials will be used solely for nonprofit purposes and will not be sold or transferred to other parties for commercial use.

I will not receive any monetary compensation for the use of my image, likeness, or voice.

My participation is entirely voluntary, and I can revoke this permission at any time by contacting Allies, Inc. in writing at 1262 Whitehorse-Hamilton Square Road, Hamilton, NJ 08690. Such revocation will not apply to materials already produced or published.

Signing this authorization is not a condition for receiving services from Allies, Inc.

Expiration Date: This authorization will expire one year from the document's signed date, or upon the termination of Allies, Inc.'s promotional and educational initiatives, whichever occurs first.

Please complete the following information: