Hopewell-Loudon Local Schools

Release Form

(Parents Please Read, Sign and Return to School)

I agree without further obligation to me, to allow the use of my name, city, state of residence, biographical material, voice, likeness or photograph by Hopewell-Loudon Local Schools for educational purposes and in connection with program publicity and for on-air and other promotional purposes.

I agree to allow images created through photography, videography or other electronic means in which I appear to be edited, reproduced and distributed for unlimited use, in whole or in part, by Hopewell-Loudon Local Schools.

I agree to grant Hopewell-Loudon Local Schools the royalty-free, non-exclusive right and license to use, produce, modify, publish, distribute, perform and display all material, information, communications, text, graphics, links, electronic art, animation, audio, video, photos, and other data made pursuant to this Release (collectively, the “Content”) in technology now known or later developed for the full term of any intellectual property rights that may exist in such content.

I and my heirs, executors, administrators, assigns, and personal representatives agree to release and discharge Hopewell-Loudon Local Schools, its directors, officers, employees, and agents from any and all liability for any use, misappropriation or disclosure of any information.

In signing this release, I acknowledge and represent that I have read this Release, that I understand the significance of this Release, and I am signing this Release voluntarily, as my own free act and deed. I further acknowledge and represent that no oral representations, statements, or inducements, apart from the foregoing written Release have been made.

______________________________________________________________________________

Signature Print Name Date

______________________________________________________________________________

Address

______________________________________________________________________________

For Minors

I am the parent/guardian of the above minor and I fully intend this Release to be binding on myself, my spouse, my family, including, but not limited to, the minor who is the subject of this Release and/or my heirs, executors, administrators, assigns and personal representatives, with the exception that Hopewell-Loudon will not use the name of the minor who is the subject of this Release.

______________________________________________________________________________Signature of Parent/Guardian Print Name Date

______________________________________________________________________________Address

______________________________________________________________________________