Media Consent and Release Form

I hereby grant permission to _______________________________ (Nonprofit Organization), its representatives, employees, or agents, to take and use photographs, video, and/or electronic images and/or audio recordings of me in any and all of its publications, including website entries, social media, and other promotional materials, without compensation to me.

I understand and agree that these materials will become the property of the nonprofit organization and will not be returned. I hereby irrevocably authorize the organization to edit, alter, copy, exhibit, publish, or distribute these images and recordings for any lawful purpose.

I waive any right to inspect or approve the finished product in which my likeness appears.

Participant Information

Name of Participant: Email: Phone Number: Address:

I am 18 years of age or older

Parent/Guardian Consent (if under 18)

Name of Parent/Guardian: Parent/Guardian Email:

Participant Signature:

Date:

Parent/Guardian Signature (if under 18):

Date: