Please complete this form to grant permission for us to use photos, videos, or quotes that may include you (or your child) in our communications and promotional materials. "*" indicates required fields Is this release for yourself or your child?* Myself My child Both Your Name* First Last Child's Name* First Last Media Release for Adults By signing this form, I grant to Tilth Alliance, and its successors and assigns, the right to use and publish my photograph, video or voice recordings, or likeness/appearance, with or without my name, on a perpetual basis in any medium or format, for the promotional and educational purposes of Tilth Alliance. I hereby release Tilth Alliance from all claims and demands that I may have, including without limitation those based on copyright, libel, slander, violation of privacy or publicity or similar rights, arising out of or in connection with the exercise of the rights authorized hereunder.Media Release for Minors I grant to Tilth Alliance, and its successors and assigns, the right to use and publish my child’s photograph, video or voice recordings, or likeness/appearance, with or without my child’s name, on a perpetual basis in any medium or format, for the promotional and educational purposes of Tilth Alliance. I hereby release Tilth Alliance from all claims and demands that I may have, including without limitation those based on copyright, libel, slander, violation of privacy or publicity or similar rights, arising out of or in connection with the exercise of the rights authorized hereunder.Signature*Parent/Guardian signature required for minors. Δ
