Photo Submission & Use Release Form

Today's Date*

Name*

Division / Lot*

Email Address*

I hereby grant and authorize the Lake Cushman Maintenance Company the right to take, edit, alter, copy, exhibit, publish, distribute and make use of any and all pictures or video taken and submitted by me to be used in and/or for legally promotional materials including, but not limited to, newsletters, flyers, posters, brochures, advertisements, fundraising letters, annual reports, press kits and submissions to journalists, websites, social networking sites and other print and digital communications, without payment or any other consideration.*

I understand this authorization extends to all languages, media, formats, and markets now known or hereafter devised. This authorization shall continue indefinitely unless I otherwise revoke said authorization in writing. The revocation will not affect any actions taken before the receipt of this written notification.*

I understand and agree that these materials shall become the property of the Lake Cushman Maintenance Company and will not be returned.*

I hereby hold harmless, and release The Lake Cushman Maintenance Company from all liability, petitions, and causes of action which I, my heirs, representative, executors, administrators, or any other persons may make while acting on my behalf or on behalf of my estate.*

I warrant that I am of the age of consent (18 years or older) and that I am competent to contract in my own name. I have read this release before signing below and I fully understand the contents, meaning and impact of this release.*

By typing my name below, I certify that the above statements to be true and that my typed name constitutes as my signature.*

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