Download a liability waiver photorelease from the website of WaiverElectronic easily.

1.         I authorize Chartwell Retirement Residences and its subsidiaries, affiliates and partners, together with their respective agents, officers, trustees and employees (collectively referred to as “Chartwell”), to take and produce items such as, but not limited to, still photographs, moving pictures, and/or sound recordings of me (collectively the “Recordings”).

2.         I irrevocably authorize Chartwell, as well as third-party sponsors as specifically authorized by Chartwell, to use, distribute, publish, digitize, exhibit, broadcast and reproduce such Recordings in any manner or media whatsoever, without payment or any other consideration, with or without my name, anywhere in the world in perpetuity, for any lawful purpose, including but not limited to the following: news media, publicity, marketing, social media, newspaper, television, radio, magazine/newsletter, residence publications, website, advertising and fundraising.

3.         By signing this form, I authorize Chartwell, as well as third-party sponsors as specifically authorized by Chartwell, to use any personal information that they have gathered in conversations or correspondence with me or my family members so long as such information is not private, sensitive, embarrassing or negative in nature.  I understand it is my responsibility to inform Chartwell, in writing, if there is any information that I have shared that I wish to keep confidential.   

4.         I understand that by signing this form, I agree to assign all rights to any Recordings to Chartwell.  I also waive the right to inspect or approve the finished product where the Recordings appear and waive any right to royalties or other compensation arising from or related to the use of the Recordings.

5.         I hereby release, waive and forever discharge Chartwell from any and all claims, demands, and causes of action which I may have by reason of the Recordings or this Photo Authorization and Release.  It is my express intent that this Photo Authorization and Release shall bind the members of my family, my heirs, executors, administrators and assigns.

6.         This Photo Authorization and Release contains the entire agreement of the parties with respect to the subject matter of this Photo Authorization and Release, and supersedes all prior negotiations, agreements and understandings with respect thereto.  This Photo Authorization and Release may only be amended by written agreement signed by both parties.

I have read and understand this form and had the opportunity to ask questions before signing it.  I warrant that I am competent to contract in my own name.