New Summer Snorkeling Program! - Child Consent Form


PHOTO CONSENT/RELEASE FOR MINORS (under 18 years of age)

 

CONSENT/RELEASE

I hereby consent to the royalty-free use by the United States Department of Agriculture, Forest Service of photograph(s) taken of me by employees/representatives of the USDA Forest Service and of any reproduction of the photograph(s) in any form, in any media, for any purpose in connection with USDA Forest Service, world-wide, free and clear of any claim whatsoever on my part.

 

I also consent to the use with the photograph(s) of my name and any comments I may have made at the time of the photograph(s), including the editing thereof.

 

Furthermore, I understand that this consent includes consent to USDA Forest Service to use the photograph(s), with or without my name and any comments, for educational, promotional, and outreach purposes, and to use alone or in conjunction with other types of material, including use on the Internet and other means of public display.

 

I hereby release the United States, its officers, and employees from liability for any violation of any right I may have in connection with the foregoing use.

 

I hereby waive any right of inspection or approval of the photograph(s) or of the use that may be made of the photograph(s), my name, and my comment(s).

 

Signature _____________________________________Date________________________

 

Name (Print)___________________________________ Phone Number_______________

 

Address__________________________________________________________________

 

 

CONSENT/RELEASE OF PARENT/LEGAL GUARDIAN

I am a/the parent/legal guardian of the minor who executed the foregoing Consent/Release.  Acting both for myself individually and on behalf of said minor, I hereby consent to the execution of the foregoing Consent/Release by said minor and agree to the provisions thereof.

 

Signature ______________________________________Date______________________

 

Name (Print)___________________________________Phone Number_______________

 

Relationship to the Minor_______________________ Email (Optional)________________

 

Address__________________________________________________________________

 

USDA Forest Service Photographer contact:

Name ____________________________________Phone Number___________________

 

USDA is an equal opportunity provider and employer.