Active Aging
Partnership
Blueprint
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Activity Links
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Open Bulletin Board/
Questions about
Physical Activity
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Physically Active
Role Models
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about the Blueprint
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New Active Green
Environments Project
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Tai Chi Project
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Physically Active Role Models
Photo Release Form I hereby give Active Aging Partnership the absolute right and permission to copyright and/or publish the photographic portraits or pictures of ___________________________. I agree that the photograph becomes the exclusive property of the Active Aging Partnership and I waive all rights hereto. I waive all rights to inspect and/or approve copy that may be used in conjunction with the photograph and the use to which it may be applied. The photograph--whole, in part, or composite--may be used as the Partnership sees fit in the publication of educational materials, for websites, and for any other lawful purposes. Date: _________________ Model Name:________________________________ Address:________________________________________ ______________________________________________ Phone number: _______________________________ May we contact you for more information about your physical activities?
Yes ___________ Send model release with entry form to:
Lisa Sheppard |