Photograph, Film, Videotape, Movie, Internet, and/or Sound Recording Release Form

AUTHORIZATION AND RELEASE 

 By signing this page, I agree to permit photographs, video or digital tapes, movies and/or sound recordings of myself (or my child) for the purpose of television, radio, newspaper or outdoor advertising, billboards, bus covers, videos, printed materials, internet and/or news stories. I understand that I (or my child) will not receive payment for these pictures and will have no right to view or approve them before or after they have been used. I also understand that there is no time limit to this agreement.

I hereby authorize and consent that Bridgeport Prospers/United Way of Coastal and Western Connecticut and United Way, not-for-profit corporations, legal representatives, successors or assigns, shall have the absolute right to copyright, publish, use, sell or assign any and all photographic portraits or pictures, television spots, movie films, videotapes, internet postings/web publishing, and/or sound recordings, or any part thereof, they have taken or made of me on this date(s) or in which I may be included in whole or part, whether apart from in or connection with, illustrative or written printed matter, story or news item, motion pictures, television or radio spots, world wide web published, or for publicity, advertising or any other lawful purpose whatsoever, in conjunction with my own or a fictitious name, or in reproductions thereof in color or otherwise. I hereby waive all claims for any compensation for such use or for damages. I hereby waive any right that I may have to inspect and/or approve the finished product or the advertising copy that may be used in connection therewith or the use to which it may be applied. I hereby warrant that I am of full age and have the right to contract in my own name in the above regard. I state further that I have read the above authorization and release, prior to its execution, and that I am fully familiar with the contents thereof.