Photography Model Release

Tatton Brown Rahman Syndrome Community

Photo/Video Release Form
Photo Release
Full Name (may be parent or guardian)*

First NameLast Name
Name of Minor (if applicable)

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
E-mail*
A. Image Release

I hereby give The Tatton Brown Rahman Syndrome Community the absolute and irrevocable right and permission, worldwide, in perpetuity with respect to the photographs and videos that he/she has taken (or that photos and videos that I have provided) of myself and/or my minor child in which he/she may be included with others:

a) To copyright the same in Tatton Brown Rahman Syndrome Community’s name or any other name that he/she may select;

b) To use, re-use, publish and re-publish the same in whole or in part, separately or in conjunction with other photographs and/or videos in any medium now or hereafter known, and for any purpose whatsoever, including (but not by way of limitation) illustration, promotion, advertising and trade, and;

I hereby release and discharge Tatton Brown Rahman Syndrome Community from all and any claims and demands ensuing from or in connection with the use of the photographs and/or videos, including any and all claims for libel and invasion of privacy.

B. Liability

Tatton Brown Rahman Syndrome Community is not responsible for any injuries inflicted upon any participating parties. Participant(s) will be responsible for their children and for themselves and release photographer from any claims against their person or their business.
I have read and understand the terms of this photo/video release with Tatton Brown Rahman Syndrome Community.
Signature*

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Tatton Brown Rahman Syndrome Community