PHOTO/ VIDEO RELEASE FORM

Photo/Video Release Form
Name *

First NameMiddle NameLast Name
Name

First NameMiddle NameLast Name
Company Name (if applicable)
Date:

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Date
Address (optional)

Street Address

Street Address Line 2

CityState / Province

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E-mail*
Phone Number

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I do hereby give permission to the following resort(s), its agents, and others working under its authority, full and free use of video/photographs either created by me and/or containing my image/likeness. I understand these images may be used for marketing, promotional, news, and/or other similar purposes, including use on the resort(s)' website(s).
Kindly note that we do like to cross promote the sister resorts, so we truly appreciate your permission in using the images for all websites & similar marketing channels.
Coco Plum Island Resort, Dangriga, BelizeManta Island Resort, BelizeBelizean Dreams Resort, Hopkins, BelizeLaru Beya Resort, Placencia, Belize
I hereby release, discharge, and hold harmless the above resort(s) and its agents from any and all claims, demands, or causes of action that I may hereafter have by reason of anything contained in the photographs or video.
I have read the foregoing release, authorization and agreement, before affixing my signature below and warrant that I fully understand the contents thereof.
Signature*

Clear
EZ Investments
P.O. Box 239 Dangriga, Belize C.A.
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Photo/Video Release Form