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Photographer Information
Name to be printed in publications.
Photographer Name
First
Last
Member Information
Member Name
First
Last
SREC Account #
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Address
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- None -
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Photo Information
Location of Photo
Photo Title
To be included in the photo caption.
Photo Upload
Maximum 3 files.
20 MB limit.
Allowed types: gif, jpg, jpeg, png.
Signature
By signing below, I certify that the photo(s) I am submitting is my original work and has never been copyrighted or, if copyrighted, that I am the sole copyright owner. I also agree to allow Scenic Rivers Energy Cooperative to use my photograph(s) and name for any promotional and advertising purposes, now, or at any time in the future, without compensation and without any claim against Scenic Rivers Energy Cooperative. I further certify that I have obtained any required permissions from any people(s) photographed to share, distribute and or use their likeness in the submitted photo(s). I understand the photograph may be used in paper reproductions and/or computer images displayed on the Scenic Rivers Energy Cooperative website or social media pages.
Parent/Guardian Signature
I, the undersigned, am the legal guardian of the photographer listed above, a minor child. With my signature, I grant my permission to Scenic Rivers Energy Cooperative to reproduce the above-named child’s name and photograph and visual image of the above-named child for use in its marketing material, including, but not limited to paper reproductions and computer images display on the Scenic Rivers Energy Cooperative website. I acknowledge and agree that neither I nor the child will not now, or at any time in the future, receive any compensation or have any claim against Scenic Rivers Energy Cooperative for the use of the name or reproduction of the child’s picture or visual image in its marketing material.
Date Signed