Photo Release and Authorization/Consent for Use or Disclosure of Information for Publication Purposes

I hereby grant to the Fluvanna Community Historical Society (FCHS), FCHS's officers, employees, clients, legal representatives, and assigns, those for whom FCHS is acting, and those acting with FCHS's authority and permission, the absolute right and permission to copyright, in FCHS's own name or otherwise, and use and re-use still/video pictures of me or in which I may be included, in whole or in part, without restriction, in conjunction with my own or a fictitious name, or reproductions thereof in color or otherwise, made through any medium, and used in any and all media now or hereafter known for illustration, promotion, art, advertising, trade, or any other purpose whatsoever, in perpetuity and on a worldwide basis.

 

I hereby waive any right that I may have to inspect or approve the finished product or products and the advertising copy or other material that may be used in connection therewith or the use to which it may be applied.

 

I understand that I will not receive any payment or compensation for the use or disclosure of any photographs or likenesses of me or the use or disclosure of any other information about me for publication purposes.

 

I release, discharge and agree to hold harmless FCHS, FCHS's officers, employees, clients, legal representatives, and assigns, and all persons acting under FCHS's permission or authority or those for whom FCHS is acting, from any liability by virtue of any blurring, distortion, alteration, optical illusion, or use in composite form, whether intentional or otherwise that may occur or be produced in the use of my likeness as provided above, including without limitation any claims for libel or invasion of privacy.

 

I hereby warrant that I am of full age and have the right to contract in my own name and grant these rights without violating the rights of any third party. I have read the above agreement, prior to its execution, and I am fully familiar with the contents thereof. By clicking on the checkbox on the registration and booking page for this event or the authorization page on the submission form or similar page, next to the statement that reads as follows, 'I agree to the Photo Release and Disclosure of Information" I agree that this agreement and all of the above shall be binding upon me and my heirs, legal representatives, and assigns.

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Furthermore, by clicking on the checkbox on the registration and booking page for this event or the authorization page on the submission form or similar page, next to the statement that reads as follows, "I agree to the Photo Release and Disclosure of Information" I confirm that I am the parent/guardian of any minor I allow to participate in this event and I consent to the terms of this Photo Release and Authorization/Consent for Use or Disclosure of Information for Publication Purposes with respect to that minor.