Price Family Legacy Media & Testimonial Release
For Legacy Systems Build and affiliated brands/projects.
Please read and acknowledge the following release:
Release Statement:
I hereby grant Price Family Legacy LLC, Legacy Systems Build, Polar Express Ice, and their affiliated brands the unrestricted, perpetual, worldwide right and authorization to use, reproduce, publish, display, distribute, modify, adapt, and otherwise exploit my photograph(s), video(s), testimonial(s), likeness, name, voice, and any biographical material in any and all media now known or hereafter developed. This release applies to client websites, marketing campaigns, portfolio examples, and any current or future digital properties created, managed, or operated by Legacy Systems Build. Authorization includes, but is not limited to, use on websites, social media platforms, online and offline advertisements, promotional materials, portfolio showcases, printed materials, and future campaigns. I agree that such uses may be for marketing, promotional, advertising, editorial, or other lawful purposes, without compensation to me. I understand that I may request removal by contacting the company.
Full Legal Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Company/Organization (if applicable)
Are you 18 years of age or older?
*
Yes, I am 18 or older
No, I am under 18 (Parent/Guardian must complete below)
Parent/Guardian Information (if signer is under 18)
Parent/Guardian Full Name
First Name
Last Name
Parent/Guardian Email
example@example.com
Parent/Guardian Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Optional: Upload a Photo
Upload a File
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Optional: Share your testimonial
Date
*
-
Month
-
Day
Year
Date
I acknowledge that I have read, understood, and agree to the terms of this Media & Testimonial Release.
*
I agree
Electronic Signature
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