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3. 

6. I, the undersigned, hereby grant permission to the City of Valdez, its officers, employees, agents, and assigns (the “City”), to take, use, reuse, publish, republish my likeness (photographic, video-form or otherwise) and voice, for the purposes of advertisement, fundraising, publicity, promotion, trade or any other use by the City, in any and all forms, media and manners, including but not limited to, news releases, websites, social media, photographs, video, marketing and exhibition for an indefinite period of time.

   I understand and agree that these images and voice recordings may be used for a variety of purposes, as outlined above, without further notification. And as such, I further agree that I do not have any rights to inspect or approve the finished photographic, video, or audio-recorded products.

   I acknowledge that no compensation, fee, or royalty will be paid for the uses mentioned above of my likeness or voice and that the City owns all rights to the images, video, and recordings and all derivative works created therefrom.

   I release the City, its officers, agents, and assigns from any and all claims, demands, damages, and liabilities arising out of, or in connection with, the use or distribution of said photographs, video, or audio recordings, including but not limited to, claims of invasion of privacy, defamation, or infringement of copyright, moral rights, or rights of publicity.

   This Release expresses the complete agreement of the parties and supersedes all prior communications, contracts, or agreements between the parties with respect to the subject matter of this Release, whether oral or written.

8. Personal Information
10. Name of Person in Photo, Video, or Audio Recording*
12. Address*
14. City*
15. State*
16. Zip Code*
18. Primary Phone Number*
19. Email Address*
21. Photo, Video, or Audio Information
23. Name of Person Who Took the Photo, Video, or Audio Recording*
24. Date of Photo, Video, or Audio Recording*
26. Description of Photo, Video, or Audio Recording*
28. Agreement & Submission*

    By checking the "I agree" box, I attest that I have read the City of Valdez Photo, Video, and Audio Release Form (Adult) and fully understand its contents.

    1. I agree.
29. Date*
Leave This Blank:


31. 1. Receive an email copy of this form.
32. Email address

    This field is not part of the form submission.

33. Submit

* indicates a required field