Gippsland photo release

Photo release form Gippsland Social Enterprise Collective

Thank you for taking the time to fill out this form so that we can the produce a short video / photo montage promoting social enterprises, as well as for reporting and promotional purposes.

We will not use these images or videos or any other information provided for any other purpose.
This Photo Release (“Release”) is made on this day:*
MM slash DD slash YYYY
By entering my name and submitting this form, I grant and authorise GSEC (Gippsland Social Enterprise Collective), and SENVIC (Social Enterprise Network Victoria), the right to edit, alter, copy, and make use of all photos and or video taken of me for promotional materials. This grant of use is without payment or consideration and includes (but is not limited to) publishing on the internet and social media, in printed and promotional materials, and for any other lawful purpose. I understand and agree that these materials are the property of GSEC and may be used by third parties to promote social enterprise or support GSEC’s aims. This Release extends to all media, languages, and formats existing now or in the future. I waive any right to royalties or other compensation and release rights to all claims, demands, and causes to action related to this Release.

I understand and agree that if I wish to withdraw this authorisation, it will be my responsibility to inform GSEC in writing: gippsland@senvic.org.au.
Signed*
- I am over 18 and give my consent
- I am a parent/guardian of a person younger than 18 years old and grant permission on their behalf
Name of participant*
Name of Child*
Parent/guardian name*
Contact - email address or phone number*
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Name
This field is for validation purposes and should be left unchanged.