Posted by Steve Vos

South Grandville recognizes that we live in world where it is necessary to protect our children and respect the privacy of individuals of all ages. In order to be effective in doing so, we have drafted the below brief statement that doubles as a photo release form for use in our multimedia. If you have questions or concerns about specific usage, feel free to contact a member of the technology committee and they would be glad to help.

 

South Grandville CRC Photo Release Form

For valuable consideration received, I grant to South Grandville CRC and its representatives and assigns, the irrevocable and unrestricted right to use and publish photographs of me, or in which I may be included, for editorial, trade, advertising, and any other purpose and in any manner and medium; and to alter and composite the same without restriction and without my inspection or approval. I hereby release South Grandville CRC and its representatives and assigns from all claims and liability relating to said photographs.

I have read this release form carefully and fully understand its meanings and implications.

 

 

  SIGNATURE (sign above)  
 

NAME

 
   

DATE OF BIRTH

 
   

TODAY’S DATE

 
   

PHONE

 
   

STREET ADDRESS

 
   

CITY, STATE, ZIP

 

 
IF MINOR, SIGNATURE OF PARENT/GUARDIAN

 

 

 
SIGNATURE OF WITNESS  
   

WITNESS (Print Name)