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Model Release Form

Please print this page and include a signed copy with photos submitted via mail to any Dominion Parenting Media magazines (including Boston Parents Paper, Westchester Family, Colorado Parent, Our Kids San Antonio, Bay Area Parent, and L.A. Parent).


Submission of photos grants permission to Dominion Parenting if it so chooses to publish your photos in print or electronically, now or in the future, with no compensation to you. You waive any right to inspect or approve any printed matter that may be used with the photos. You hereby release, discharge and agree to hold harmless Dominion Parenting and those acting with their authority and permission, from any liability for any reason whatsoever including but not limited to any blurring, distortion, alteration, optical illusion, misprint, or use, whether intentional or otherwise, that may occur or be produced in the publishing of the Photographs, or in any subsequent processing or publication thereof, including without limitation any claims for libel or invasion of privacy. By submitting the photo, you also represent and covenant that the photos do not violate the intellectual property rights, including but not limited to copyright, of any other person or entity. If you have submitted photos of any minor child, you represent and covenant that you have the right to do so, and to agree to the above terms and conditions on behalf of any such minor child.


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Name

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Address

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City, State, ZIP
  

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Signature

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Date

 

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