Photo Release Form
Diaper Bank of Southern Arizona
By offering a donation and submitting a child photo I hereby grant to the Diaper Bank of Southern Arizona (the Diaper Bank) the absolute and irrevocable right and unrestricted permission to use the submitted photo on the Diaper Bank web site. The Diaper Bank agrees to limit use of the photo to display on the Online Nursery page(s) and not use the image for any other purpose whatsoever without express permission of the parent or guardian of the child depicted in the photograph.
Upon signature of this photo release form I hereby waive any right to inspect or approve the finished product used in connection therewith or the use to which it may be applied.
I hereby release, discharge and agree to save harmless the Diaper Bank, its legal representatives or assigns and all persons acting under its permission or authority, from any liability in connection with the use of the photographs as aforesaid or by virtue of any alteration, processing or use thereof in composite form, whether intentional or otherwise, as well as any publication thereof.
Signature of Parent or Guardian: ____________________________________________
Printed Name of Minor: ___________________________________________________
Address: _______________________________________________________________
City: _______________________________ State: ___________ Zip: ______________
Email: __________________________________________________________________
(Please print out and complete form and return with your donation and photo submission.)