Photo, Video, & Audio Release And Consent Form For The Dragonfly Foundation

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I, the undersigned, do hereby irrevocably grant permission to The Dragonfly Foundation ("Dragonfly"), a non-profit organization, its employees, representatives, successors, assigns, and affiliates, to take photographs, recordings, and other digital images of the the following:
Release Applies To:

I understand that The Dragonfly Foundation may use or publish the photographs, recordings and other digital images in print or electronic promotional, informational, or educational materials, including without limitation use on advertisements, video communication, websites, blogs, electronic mailings and presentations, newsletters, news releases, and/or other print or electronic communication.  I further grant permission to the photographer or videographer of said photographs and digital images and recordings the rights to use the same in his or her own print or electronic communications.  I understand and agree that the use of such photographs and other digital images and recordings is at the discretion of Dragonfly and/or the photographer, and that I will have no control over the design, layout, editing, alteration, and use of the same.

I authorize the aforementioned use of these photographs, recordings and other digital images without compensation to me (or my minor children, if applicable). I agree that the name, identity, diagnosis and/or treatment, as well as relationship to The Dragonfly Foundation of the subject of each photograph, recording, or digital image may be revealed in descriptive text or commentary in connection with such photograph or image.  All prints, digital reproductions, and other recorded images shall be exclusively the property of The Dragonfly Foundation.
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