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Release and Consent Form

I hereby grant permission to the rights of my image, likeness, and sound of my voice as recorded on audio or video tape without payment or any other consideration. I understand that my image may be edited, copied, exhibited, published or distributed and waive the right to inspect or approve the finished product wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of my image or recording. I also understand that this material may be used in diverse settings within an unrestricted geographic area.


Photographic, audio or video recordings may be used for the following purposes:

• Print Materials (including but not limited to magazines, trade books, flyers and brochures)

• Promotional Materials

• Social Media

• Organization’s Website


By signing this release I understand this permission signifies that photographic or video recordings of me may be electronically displayed via the Internet or in a public setting.


There is no time limit on this release’s validity nor any geographic limitation on where these materials may be distributed.


This release applies to photographic, audio, or video recordings collected within the organization and/or by the organization’s staff on and off the business’s primary location.


By signing this form I acknowledge that I have completely read and fully understand the above release and agree to be bound thereby. I hereby release any and all claims against any person or organization utilizing this material.


Please select a first and second option date and time. We cannot promise we will be able to accommodate your first choice, but we will do our best.


Art Session will be held on June 10, 2023 at 11:00 AM- 3:00 PM

If you have any questions or concerns please contact our Project Assistant, Vanessa Arteaga, via email:

Thanks for submitting!

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