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Name of Individual Photographed
Address
Platforms Where Photos Can Be Shared
Can We Use Your Name?
What Portions of the Image(s) Can We Use?
Conditions
I hereby grant The 1001 Words, its directors, officers, employees, agents, and designees (collectively “The 1001 Words”) non-revocable permission to capture my image and likeness in videotapes, motion pictures, recordings, or any other media (collectively “Images”). I acknowledge that The 1001 Words will own such Images and further grant the The 1001 Words permission to copyright, display, publish, distribute, use, modify, print and reprint such Images in any manner whatsoever related to The 1001 Words business as detailed above, including without limitation, publications, advertisements, brochures, web site images, or other electronic displays and transmissions thereof. I further waive any right to inspect or approve the use of the Image by the The 1001 Words prior to its use. I forever release and hold the The 1001 Words harmless from any and all liability arising out of the use of the Images in any manner or media whatsoever, and waive any and all claims and causes of action relating to use of the Images, including without limitation, claims for invasion of privacy rights or publicity.

I hereby warrant that I am eighteen (18) years old or more and competent to contract in my own name or, if I am less than eighteen years old, that my parent or guardian has signed this release form below. This release is binding on me and my heirs, assignees and personal representatives.