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Image Release Form

I, , hereby grant permission to adensmom.com (hereafter, “Site”) to use publish, reproduce, and edit the Photograph(s) listed below, in whole or in part, in, on, or in connection with the Site and the Site’s social media (the “Photographic Use”).

This authorization shall continue indefinitely, unless I otherwise revoke this authorization in writing by contacting [email protected].

Brief description of the Photograph(s):

The Photograph(s) were shared with adensmom.com via

Facebook

Instagram

I certify that I am the original copyright owner of the Photograph(s).

I understand that no money (zero dollars) is exchanged for this authorization. I also acknowledge that my authorization does not establish any financial relationship whatsoever between myself and the Site, unless delineated in a separate written agreement signed by both parties.

I waive the right to inspect or approve any finished product in which my likeness or the likeness of my children (if applicable) appears.

I hereby hold harmless and release the Site from any liability arising from the Photographic Use, including that based on copyright infringement, invasion of privacy, right of publicity, libel, defamation, or false light.

IF YOUR CHILDREN ARE IN THE PHOTOS: You, the parent or legal guardian of the Minor(s) listed below, are entering into this agreement on his/her/their behalf.

Please list their first and last name(s) below:

Leave blank or write N/A if there are no minors pictured.

If there are Minor(s) pictured in the Photographs, you hereby represent that

- You are a legal adult and have the full legal capacity to execute this release;
- You are the parent or legal guardian of the Minor(s) listed above, and have full authority to grant this consent on behalf of the Minor(s).

January 19, 2021

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Your legal name

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I agree that I am and I agree this is a legal representation of my signature for all purposes just the same as a pen-and-paper signature

I agree that I am and I understand this is a legal representation of my signature

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Timestamp

Audit

May 27, 2020 6:44 pm PST

Image Release Form Uploaded by Lauren Levy OBrien - [email protected] IP 73.222.70.17