Permission for Photography & Videography
For valuable consideration received, I grant to Evergreen Media and its assigned staff or freelance contractor(s) (“Photographer”) the absolute and irrevocable right and unrestricted permission concerning any photographs / videography that he/she/they has/have taken or may take of me or in which I may be included with others, to use, reuse, publish, and republish the photographs and or video in whole or in part, individually or in connection with other material, in any and all media now or hereafter known, including the internet, and for any purpose whatsoever, specifically including illustration, promotion, art, editorial, advertising, and trade, without restriction as to alteration; and to use my name in connection with any use if he/she so chooses. I release and discharge Photographer from any and all claims and demands that may arise out of or in connection with the use of the photographs, including without limitation any and all claims for libel or violation of any right of publicity or privacy. This authorization and release shall also inure to the benefit of the heirs, legal representatives, licensees, and assigns of Photographer, as well as the person(s) for whom he/she/they took the photographs. I am a legally competent adult and have the right to contract in my own name for myself, my child(ren), or children over whom I hold legal custody.
Subjects Name
Name of parent/guardian
(if applicable)
Contact telephone number
Location of Photography
Date of photography
MM
/
DD
/
YYYY
I have read this document and fully understand its contents. This release shall be binding upon me and my heirs, legal representatives, and assigns.
Yes
No
Signature
Clear
SEND
Please wait...
Never submit sensitive information such as passwords.
Report abuse
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Create online forms and surveys
Create your own form