• Veteran Photo and Story Release Form

    Veteran's Monument and Memorial Book, Union of Ontario Indians, Anishinabek Nation, Questions? Email: Inquiry_Reconciliation@anishinabek.ca
  • 1a. Family Members of Deceased Veterans

    If submitting materials on behalf of a deceased veteran:
  • I declare that I am the veteran's ______________ and that I have authority to provide the materials and grant this consent:
  • Military Service Information:

  • 1b. Self-nomination as Veteran

    If submitting on my own behalf:
  • Military Service Information:

  • 2. Materials Being Submitted

  • I am providing the following materials to the Union of Ontario Indians (check all that apply):
  • 3. Consent for Use and Publication

  • I voluntarily provide the materials identified above and grant the Union of Ontario Indians a non-exclusive, royalty-free, worldwide, perpetual licence to:

    • Collect, store, preserve, and archive the materials;
    • Reproduce, publish, distribute, display, exhibit, and communicate the materials to the public;
    • Use the materials in print, digital, audio, video, online, social media, educational, promotional, commemorative, historical, and archival formats;
    • Include the materials in publications, reports, websites, exhibits, presentations, documentaries, and future projects related to the Organization's mandate.

    I understand that the materials may be viewed by members of the public.

  • 4. Permission to Edit

  • I authorize the Union of Ontario Indians to edit, format, crop, digitize, enhance, transcribe, summarize, or otherwise modify the materials for publication, clarity, accessibility, technical quality, or space requirements, provided the original meaning of my story is not materially altered.

  • 5. Ownership and Authority

  • I represent and warrant that:
  • I further confirm that, to the best of my knowledge, use of the materials by the Union of Ontario Indians will not infringe the rights of any third party.

  • 6. Attribution

  • Please indicate how you or the deceased relative would like to be identified:
  • By selecting one of the above options, I consent to the publication of identifying information associated with my submitted materials.

  • 7. Privacy Notice

  • I understand that personal information collected through this form will be used for administering the project, maintaining records, and publishing approved materials.

    The Union of Ontario Indians will collect, use, retain, and disclose personal information in accordance with applicable privacy laws and organizational policies.

  • 8. Withdrawal of Consent

  • I understand that I may withdraw my consent at any time by providing written notice to the Union of Ontario Indians.

    I further understand that:

    • Withdrawal of consent will apply only to future uses of the materials; and
    • Materials already published, distributed, archived, or incorporated into printed publications, websites, exhibits, or other products may not be capable of being removed or recalled.
  • 9. No Compensation

  • I understand that I will not receive compensation, royalties, or other payment for the use of the materials unless otherwise agreed in writing.

  • 10. Release

  • I release and discharge the Union of Ontario Indians, its employees, agents, contractors, successors, and assigns from claims arising from the authorized use of the materials, including claims relating to publication, reproduction, or distribution of the materials in accordance with this consent

  • 11. Declaration

  • I have read and understood this form. I freely and voluntarily consent to the collection, use, publication, and archival preservation of the materials described above.

  • Format: (000) 000-0000.
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  • Should be Empty: