Photo Release Form

Share a selfie and a quote about why you love the library to be entered into the prize giveaway!

Tip: don't want your whole face featured? Grab a favorite book, peek over the top and snap a pic! NOTE: First names and last initials will be used on Facebook, in publications, etc. (i.e. John S.)
Beats Solo 4 Headphones$100 Disney GiftcardKindle Fire HD 8
Your Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
What do you love about the library? What does the Eustis Memorial Library mean to you? Any special memories or moments you'd like to share?*
Upload your photo(s) here!*

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Minors (under the age of 18) who appear in photographs must have a parent or legal guardian sign this release form. Subjects 18 years and older may sign their own form.

PUBLICITY RELEASE & PERMISSION FOR USE

By signing my name below, I hereby grant the Eustis Memorial Library the right to use my photo entry and my quote in any and all of its publications (including online use, such as Facebook, the library's website, etc.)

I hereby irrevocably authorize the Eustis Memorial Library to edit, alter, copy, exhibit, publish, and distribute the photo(s) as the organization chooses. I waive any right to royalties or other compensation arising or related to the use of the photograph(s). In addition, I waive the right to inspect or approve the finished product before it is displayed. I hold Eustis Memorial Library harmless, releasing and forever discharging any and all claims, demands, and causes of actions which I, my heirs, representatives, executors, administrators, or any other persons acting on the behalf of my estate have or may have by reason of this authorization.

I am 18 years of age or older and competent to contract in my own name. I have read this release before signing below, and I fully understand the contents, meaning, and impact of this release.

If under the age of 18, I will have consent signed by my parent or guardian.
Name of Legal Guardian (if photo subject is under the age of 18)

First NameLast Name
I am the subject of the photo (if subject is under 18, they have parent/guardian permission to enter).My photo is suitable for viewers of all ages.I understand that my photo(s) will ONLY be eligible for the prize drawing if they meet all the criteria.
Signature*

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Please verify that you are human*
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Share a selfie and a quote about why you love the library to be entered into the prize giveaway!