PHOTO AND MEDIA RELEASE FORM
Parent/Guardian Name(s):
Phone:
Format: (000) 000-0000.
Email:
example@example.com
Dependent:
DOB:
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Dependent:
DOB:
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Dependent:
DOB:
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Dependent:
DOB:
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PERMISSION, CONSENT, AND RELEASE
I hereby grant Arts for All and Alamo Heights UMC permission to use my/my dependent(s) (indicated above) likeness in a photograph, video, audio recordings, or other digital media ("photo") in any and all of its publications, including web-based publications, without payment or other consideration.
I understand and agree that all photos will become the property of Arts for All and Alamo Heights UMC and will not be returned. I also understand that once an image is posted on the website or other online platform, the image can be downloaded by any computer user, anywhere in the world. Arts for All and Alamo Heights UMC commits to eliminating any identifying information including name and age from the publication.
I hereby irrevocably authorize Arts for All and Alamo Heights UMC to edit, alter, copy, exhibit, publish, or distribute these photos for any lawful purpose. In addition, I waive any right to inspect or approve the finished product wherein my/my dependent(s) likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of the photo.
I hereby release, discharge, and agree to indemnify and hold harmless Arts for All and Alamo Heights UMC, its officers, agents and/or designated leadership, from all claims, demands, and causes of action that I or my dependent have or may have by reason of this authorization or use of my dependent's photos, including any liability by virtue of any blurring, distortion, alteration, optical illusion, or use in composite form, whether intentional or otherwise, that may occur or be produced in the taking of said photos, or in processing tending towards the completion of the finished product, including, but not limited to, publication on the internet, in brochures, or any other advertisements or promotional materials.
I HAVE READ AND UNDERSTAND THE ABOVE PHOTO AND MEDIA RELEASE.
Signature:
Date:
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