IMAGE & AUDIO USE AGREEMENT & RELEASE FORM

We frequently capture visual content during our workshops, one-on-one appointments, and in-person interactions for future utilization in marketing material, social media, website updates, newsletter, and program promotion, as well as grant funding applications. It is necessary for us to obtain a media release in order to use any photography or video of you, your child, or your organization to protect your privacy.

If you have been sent this form, it is because you have participated or will participate in one of Cut it Forward’s programs, are a Partner, Donor, or Volunteer. Please complete the form, even if you are not giving consent and indicate such in the drop downs below.

If you would like to support our mission by allowing us to use photos and/or videos of you or your child, select the options below that validate your consent. Please carefully read the legal statement below and submit the form to formalize your consent.

THANK YOU!

Subject

Your Name

First Name

Last Name

Affiliated Organization or Business Name

Child's Name

First Name

Last Name

Additional Child(ren)'s Name(s)

Use this space to add the names of any children not listed above

Phone

(###)

###

####

Full Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Consent

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LEGAL STATEMENT

I hereby grant CIF - CUT IT FORWARD the right to use audio, full motion video or still pictures/ photographs of my organization, myself, and/or my child for use in marketing materials ie: print, social media, website, commercial interviews, news stories and/or articles. Consideration: I understand that neither my organization/ nor I / nor my dependent child will be paid for giving CIF - CUT IT FORWARD rights to audio, video, or still pictures/ photographs. I know that the agency will incur expenses in reliance on this signed agreement & release form, and I will not revoke my consent. Release: In submitting this online form, I agree not to bring legal action against CIF - CUT IT FORWARD, its parent, affiliated and subsidiary companies and/or their employees for CIF - CUT IT FORWARD’s use of my organization, my, or my child’s audio, video, or still pictures/ photographs. In submitting this online form, I have not relied on any representations or other statements, which are not contained herein. I agree that no oral agreements are binding on CIF - CUT IT FORWARD unless and until reduced to writing and signed by an authorized representative of CIF - CUT IT FORWARD. Consent: I represent & warrant that I have full right, power and authority to grant the right of use of audio, video, or still pictures/ photographs of my organization, myself, and/or my dependent child. This agreement & release shall be performed at least in part in the state of Oklahoma whose laws shall govern and whose courts shall have exclusive jurisdiction over any dispute relating to this signed form. Select From the Drop Down List:

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IMAGE & AUDIO USE AGREEMENT & RELEASE FORM

© 2021 CUT IT FORWARD

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