Photograph and Publicity Consent Release Form
Photograph and Publicity Release Form - Sample
I, ________________________, give the AmeriCorps Nonviolence KOPS Program and its fiscal agent, the Michigan Institute for Nonviolence Education (MINE), permission to use my name, likeness, image, voice, and/or appearance as such may be embodied in any pictures, photos, video recordings, audiotapes, digital images, and the like, taken or made on behalf of the KOPS Program or MINE activities. I agree that the KOPS Program and MINE have complete ownership of such pictures, etc., including the entire copyright, and may use them for any purpose consistent with the KOPS/MINE’s missions. These uses include, but are not limited to illustrations, bulletins, exhibitions, videotapes, reprints, reproductions, publications, advertisements, and any promotional or educational materials in any medium now known or later developed, including the Internet. I acknowledge that I will not receive any compensation, etc for the use of such pictures, etc., and hereby release the KOPS / MINE and its agents and assigns from any and all claims which arise out of or are in any way connected with such use.
I have read and understood this consent and release.
I give my consent to the KOPS/MINE to use my name and likeness to promote the KOPS program, its fiscal agent, and/or their activities.
___________________________________________ __________________
signature date
___________________________________________ ___________________
parent / legal guardian (if age 17) date
I do not give my consent to the KOPS/MINE to use my name and likeness to promote the KOPS program, its fiscal agent, and/or their activities.
___________________________________________ __________________
signature date
___________________________________________ ___________________
parent / legal guardian (if age 17) date
................
................
In order to avoid copyright disputes, this page is only a partial summary.
To fulfill the demand for quickly locating and searching documents.
It is intelligent file search solution for home and business.
Related download
- consent to use name and or photos
- visitor confidentiality agreement ccasa
- vehicle consignment and sales agreement
- photograph and publicity consent release form
- lobby notice requirements bankersonline
- preschool anecdotal samples desired results
- middle school art sketchbook assignments
- sample informed consent form welcome roane state
- photo release form for minors flls
Related searches
- medical records release form printable
- printable medical release form pdf
- hipaa release form printable
- hipaa medical release form pdf
- education records release form printable
- doctor release form to return to work
- transcript release form template
- medical records release form canada
- generic medical release form pdf
- photography release form for printing
- free photo release form pdf
- lean release form for car