Photography consent & release form

Site Location

Parent/Guardian Information:

If the participant is under the age of 18, a parent or legal guardian must consent to participate.

Parent/Guardian First Name

Parent/Guardian Last name

Address

Child/Participant(s) Information

Please provide the name and age of each participant attending the photo session, including yourself. If you have more than 5 participants, please complete the form a second time

Participant 1: First name

Participant 1: Last name

Participant 1: Age

Participant 2: First name

Participant 2: Last name

Participant 2: Age

Participant 3: First name

Participant 3: Last name

Participant 3: Age

Participant 4: First name

Participant 4: Last name

Participant 4: Age

Participant 5: First name

Participant 5: Last name

Participant 5: Age

Consent:

By giving consent in this waiver form, you are agreeing for RetroMax Pte. Ltd. to have irrevocable permission to use, re-use, publish, and re-publish any and all photographs, video or audio from this session or derivations of the same without restriction and throughout the world to the following “Permitted Parties”: (1) RetroMax Pte. Ltd. and its agents, (2) owners or operators of the site where the content is taken or recorded, and (3) those entities or organizations that have purchased and/or contributed funds and/or resources for the purchase of equipment at such site.

This permission shall specifically include, though not by way of limitation, the right to use photographs and video and audio of myself and my child/children and/or our likeness in advertising and other publicity materials prepared for use by RetroMax Pte. Ltd., independent sales and distribution representatives, and the other Permitted Parties. I relinquish all direct and indirect claims or rights to photographs, printed materials, videos, audio, or materials in any other media, which may be produced.

I have read this authorization, release, and agreement prior to its execution and am familiar with its contents. I am of full age and am competent to sign this release. Further, I represent that I am the parent or legal guardian of the child/children, and have the right to contract in my own name, and on their behalf.

I hereby give my consent to use my photographs according to the Terms & Conditions.

Confirm with your initials

Signature

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