Peach Concerned Citizens Inc. 

Media Release Form

I hereby grant Peach Concerned Citizens Inc. (“PCC”) permission to use my likeness in a photograph, video, or other digital media (“photo”) in all its publications, including web-based publications, without express permission, payment, or other consideration.

 

I understand and agree that all photos will become the property of the PCC and will not be returned.

 

I hereby irrevocably authorize the PCC to edit, alter, copy, exhibit, publish, or distribute these photos for any lawful purpose. In addition, I waive any 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 the photo.

 

I hereby hold harmless, release, and forever discharge PCC from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or on behalf of my estate have or may have by reason of this authorization.

 

I HAVE READ AND UNDERSTAND THE ABOVE PHOTO RELEASE. I AFFIRM THAT I AM AT LEAST 18 YEARS OF AGE, OR, IF I AM UNDER 18 YEARS OF AGE, I HAVE OBTAINED THE REQUIRED CONSENT OF MY PARENTS/GUARDIANS AS EVIDENCED BY THEIR SIGNATURES BELOW. I ACCEPT:

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