Photo/Video Release

THREE18 Photo/video
Release form

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Participants First & Last Name *

First

Last

Date Completed *

D.O.B. of Signing Party *

Choose an Option *

I am over 18 Years of Age I am completing on behalf of a minor.

I,______________ , hereby grant and authorize THREE18 the right to take, edit, alter, copy, exhibit, publish, distribute and make use of any and all pictures or video taken of me by THREE18 to be used in and/or for legally promotional materials including, but not limited to, newsletters, flyers, posters, brochures, advertisements, fundraising letters, annual reports, press kits and submissions to journalists, websites, social networking sites and other print and digital communications, without payment or any other consideration. This authorization extends to all languages, media, formats and markets now known or hereafter devised. This authorization shall continue indefinitely, unless I otherwise revoke said authorization in writing.

I understand and agree that these materials shall become the property of THREE18 and will not be returned.

I hereby hold harmless, and release THREE18 from all liability, petitions, and causes of action which I, my heirs, representative, executors, administrators, or any other persons may make while acting on my behalf or on behalf of my estate.

If the person signing is under the age of consent, then this release must be signed by a parent or guardian, as follows:

I hereby certify that I am the parent or guardian of named above and do hereby give my consent without reservation to the foregoing on behalf of this individual.

I agree to the terms listed above. *

YES NO

Parent Name of Minor Child *

First

Last

Minor Childs Date of Birth *

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THREE18 Photo/video Release form

THREE18 Photo/video
Release form