Moonshot Photo/Recording Release Form
I grant permission to Moonshot at NACET, and its agents and employees, to copyright and publish, as well as otherwise use, reuse, republish and make derivative works of, all or any part of photographs and/or motion pictures and/or voice recordings and/or written and/or spoken statements taken of me on the date(s) and at the location(s) listed below (the “Photos/Recordings”). This permission relates to any media or publication now or hereafter known, including on the Moonshot at NACET website and the internet generally, for the purposes of, but not limited to: Photos/Recordings that are printed, moving, audio, and/or electronic; and all exhibits, public displays, commercial art, illustrations, promotions, art, editorial works, and for advertising or commercial purposes. This permission is granted without limitation or reservation.
I hereby waive any right to inspect or approve the Photos/Recordings that may be used by Moonshot, now or in the future, whether the use is known or unknown to me. I also hereby waive any right to royalties or other compensation arising from or related to the use of the Photos/Recordings that may be used by Moonshot at NACET.
I hereby agree to indemnify, release and hold harmless Moonshot from and against any claims, demands, damages or liability arising from or related to the use of the Photos/Recordings, including but not limited to any claims arising from defamation or violation of any right of publicity or privacy, and also including but not limited to any re-use, distortion, blurring, alteration, optical illusion or use in composite form, either intentional or otherwise, that may occur or be produced in production of the final product. I agree that it is solely within the discretion of Moonshot at NACET to decide whether and how to use the Photos/Recordings.
This Release will be binding upon me and my heirs, legal representatives, and assigns.
Unless my parent or guardian signs where indicated on the signature lines below, I certify that I am 18 years of age or older, and I am competent to contract in my own name. I have read this Release and I fully understand the contents, meaning, and impact of this Release. [For subjects of the Photos/Recordings who are under 18, this Release must be signed by both the minor subject and his/her parent or guardian.]
In any event, I hereby consent to the disclosure of Photos/Recordings related to me as described herein. I certify that this consent is given freely and voluntarily. I may revoke this consent at any given time by providing written notice of such revocation to the Moonshot office or employee who maintains this authorization. I understand that in order to revoke this release, I must present the request in person with Moonshot accepted photo identification. I understand that this authorization remains in effect until my written revocation is received the Moonshot office or employee unless noted differently herein.
Please fill out the information below:
Moonshot at NACET
2225 N. Gemini Dr.
Flagstaff, AZ 86001
249 E. Chicago St.
Chandler, AZ 85225
AZ Stitch Lab
625 W. Rillito St.
Tucson, AZ 85705