Photo/Video Release Form


Please read and sign below:

I, the undersigned, hereby grant my permission and consent to the Seger Park Dog Owners Association (“SPDOA”) and to the Seger Park Advisory Council (“SPAC”) and the affiliates, officers, employees, and volunteers of both (together, “Seger Park Representatives”) to photograph, video record, or audio record me and/or my pet. I hereby grant an irrevocable, world-wide, royalty-free right and license to SPDOA, SPAC, and Seger Park Representatives to utilize, adapt, modify, reproduce, distribute, publicly perform and display the photographs, video, and/or audio (collectively “Media”) taken of me and/or my pet for use in promotional, educational, informational, advertising, or commercial materials and communications in any form now known or later developed, including but not limited to publications, websites, articles, brochures, newsletters, videos, films, social media, advertisements, and training programs (collectively “Materials”). Furthermore, I hereby authorize and consent to the use of my name, image, likeness, and voice (collectively, “Likeness”) and to the use of my pet’s name (if entered below) and my pet’s image, in the Media for all Materials or any other purposes deemed appropriate by SPDOA and SPAC. I hereby waive any right to be notified or to inspect or approve the Media or any Materials that are created using my Likeness or my pet’s image, now or in the future, whether that use is known or unknown to me. 

I hereby waive any right to royalties or other compensation arising from or related to the use of the Media or Materials. I hereby release and hereby agree to indemnify and hold harmless SPDOA and SPAC and their trustees, Seger Park Representatives, and their licensees and assigns for any and all claims that I or any third party may have now or in the future for invasion of privacy, right of publicity, copyright infringement, defamation, or any other cause of action arising of the use, utilization, adaptation, modification, reproduction, distribution, publicly performance or display of my Likeness in the Media or Materials. In accordance with this complete release of all rights in my Likeness used in the Media and Materials, I hereby waive any and all claims, damages, or liability arising from or related to the use of the Media, including but not limited to any misuse, distortion, blurring, alteration, optical illusion, or use in composite form, either intentionally or otherwise, of my Likeness or my pet’s image that may occur or be produced in taking, processing, reducing, adapting, modifying, producing, reproducing of the Media and Materials and their publication, distribution, display or performance. 

I understand and agree that SPDOA and SPAC are and shall be the exclusive owners of all right title and interest, including any copyright, in the Media and Materials. 

I have read this Consent, License and Release before signing below, and I fully understand the contents, meaning, and impact of this Consent, License and Release. This Consent, License and Release shall be binding upon and inure to the benefit of my successors and assigns, and contains the entire understanding of the parties with regards to the Media and Materials. 

Name *
I accept and understand the terms above and agree that completion of this field will serve as my signature
Checkbox *
If applicable, please include the name of the minor(s) for which you are a parent or legal guardian
If applicable, please include the name of your dog(s)