Photo & Video Release Form


I, , hereby authorize the Generation E Institute – Battle Creek, Michigan, to publish photographs, video, and information taken of me and/or the undersigned minor children, and our names, for the use in in the Generation E Institute’s printed publications, website, and social media.

I release the Generation E Institute from any expectations of confidentiality for the undersigned minor children and myself and attest that I am the parent or legal guardian of the children listed below and that I have the authority to authorize the Generation E Institute to use their photographs, videos, names and information.

I acknowledge that since participation in publications, websites, and social media produced by the Generation E Institute confers no rights of ownership whatsoever. I release the Generation E Institute and its employees from liability for any claims by me or any third party connection with my participation or the participation of the undersigned minor children.

Child Name: 
Age:   

Parent Contact
 

 

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Signature Certificate
Document name: Photo & Video Release Form
lock iconUnique Document ID: 28a5a7a8b5e4823f20bbc686bdc21178306023d5
Timestamp Audit
February 19, 2018 3:45 pm EDTPhoto & Video Release Form Uploaded by Cheryl Peters - staff@genei.org IP 68.55.196.224, 127.0.0.1