CONSENT TO PUBLISH

 

I hereby give the absolute, irrevocable right and permission, in connection with the photographs the photographer ________________________ (name) has taken

of me, or in which I may be included with others, and/or in conjunction    with    the written material the interviewer ________________________________(name) has developed from an interview with me, the following:

 

a.The right to use and reuse, in any manner at all, said photographs and/or written material in whole or in part, either by themselves or in conjunction with other photographs/written material, in any medium and for any purposes whatsoever, including, without limitation, all promotional and advertising use, and other trade purposes, as well as using my name in connection therewith, if the so desires; and

b.The right to copyright said photographs/written material in the name of the

I hereby forever release and discharge above-named photographer and/or writer and the __________________________from any and all claims, actions and demands arising out of or in connection with the use of said photographs and/or written materials, including, without limitations, any and all claims for invasion of privacy and libel.

I represent that I am at least eighteen years of age and that I have read the foregoing and fully and completely understand the contents hereof.

 

Signed ________________________________________________________________________

 

Printed Name __________________________________________________________________

 

Witness' Signature _____________________   

 

Date ___________________________________

 

If under 18, guardian's signature

 

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