Thank you for your participation and support! In order to protect your privacy and ensure that we have the proper authorization to use any media involving your image, we ask that you carefully review and agree to the terms below. Your consent will allow us to share photos, videos, and other media as part of our efforts to promote the Foundation and its initiatives.
Please review the release statements, and check the box in the form to confirm your understanding and agreement.
- I consent and authorize STAROSY STELLA FOUNDATION, its successors, assigns, and legal representatives (“SSF”) the irrevocable and unrestricted right to use my name, photograph, image, audio recording, video recording, and/or the like (the “image”) in all forms and manner, including, but not limited to, photographs, videos, or other digital media in any and all of its publications, including Internet web-based publications, websites, promotional material, or for any other similar purpose, without payment or other consideration to me.
- I hereby irrevocably authorize SSF to edit, alter, copy, exhibit, publish, or distribute these images for any lawful purpose. I understand and agree that all images will become the property of the SSF and will not be returned. I waive any right to inspect or approve the finished product wherein the image appears. I release and waive any claims or right to royalties or other compensation for ownership of such photograph (s), audio, or video recording(s), of me.
- I hereby hold harmless, release, and forever discharge SSF, and its owners, officers, directors, successors, assigns, and legal representatives from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or on behalf of my estate have or may have arising out of or in connection with this authorization.
- I certify that I have read and understand the above image release. This release is binding on me, my heirs, assigns, and personal representation. I also certify that I am above 18 years or older. If a parent or guardian participates in an event with his or her child, signing on behalf of the child stipulates that the parent or guardian also consents to the terms and conditions of this consent and release for him or her.