media waiver release in digital

MEDIA RELEASE FORM for “Me, Myself and The World”

I, as the name listed below, grant permission to The Jul-TV Television Network and Pamela Holt, hereinafter known as the “Media” to use my image (photographs and/or video) for use in Media publications including: (Check All That Apply) *

Videos, TV, Websites and/or Affiliates, Social Media (including but not limited to Facebook, Instagram, Twitter), Email Blasts, Newsletters, Magazines, General Publications

Please select at least one choice above.

I hereby waive any right to inspect or approve the finished photographs or electronic matter that they may be used in conjunction with them now or in the future, whether that use is known to me or unknown, and I waive any right to royalties or other compensation arising from or related to the use of the image.

Please initial the paragraph below which is applicable to your present situation:

Initial Here

- I am 20 years of age or older and I am competent to contract in my own name. I have read this release before signing below, and fully understand the contents, meaning and impact of this release. I understand that I am free to address any specific questions regarding this release by submitting those questions in writing prior to signing, and I agree that my failure to do so will be interpreted as a free and knowledgeable acceptance of the terms of this release. Please click the yellow area and provide your initials here.

Initial Here

I am the parent or legal guardian of the below named child. I have read this release before signing below, and I fully understand the contents, meaning and impact of this release. I understand that I am free to address any specific questions regarding this release by submitting those questions in writing prior to signing, and I agree that my failure to do so will be interpreted as a free and knowledge acceptance of the terms of this release. Please click the yellow area and provide your initials here.

Select Your Country: * Please select one here.

Address: *

Please enter address.

Signature of parent or legal guardian: (if under 20 years of age)

Click to sign

Please sign here.

Email: Please enter your email.

Your signature *

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Please sign here.

Your Name * Please enter your answer here.

Signature Date *

Please enter valid date.

The electronic media waiver- an easy using waiver software developed by WaiverElectronic.

MEDIA RELEASE FORM for “Me, Myself and The World”