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Toggle Navigation
About the Liberty Chamber
2025 Board of Directors
Business Resources
Staff
Calendar
Community Events
Membership
Membership Levels
Membership Guide
Benefits
Join
Directory
Member Login
Sponsorship Opportunites
Join Our Mailing List
Now Hiring
Directory
Contact
Photograph & Video Release Form
Photograph & Video Release Form
2019-09-24T20:10:34+00:00
Photograph & Video Release
I hereby grant Liberty Area Chamber of Commerce permission to rights of my image, likeness and sound of my voice as recorded on audio or video tape without payment or any other consideration. I understand that my image may be edited, copied, exhibited, published or distributed and waive the right to inspect or approve the finished product wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of my image or recording. I also understand this material may be used in diverse educational settings within an unrestricted geographic area and may be electronically displayed via the Internet. There is no time limit on the validity of this release.
Authorization
*
I agree
By checking this box and typing my name below, I am electronically signing the photograph & video release form. I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature.
Name
*
First
Last
Address
*
Street Address
City
State / Province / Region
ZIP / Postal Code
Phone
*
Email
*
Minor Release AUTHORIZATION
*
I agree
Not applicable
Further, I attest that I am the parent or legal guardian of the child or children listed below and that I have full authority to consent and authorize Liberty Area Chamber of Commerce to use their likenesses and names.
Relationship to Child(ren)
Name(s) of Child(ren)
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