Authorization for Release and Use of Images
For good and valuable consideration, I hereby grant Sandpiper Montessori Preschool, Wilmington, NC including it officers, employees, agents, consultants and subcontractors the following irrevocable rights:
1. The right to use my or my minor child’s name, photograph, picture, portrait reproduction and likeness (hereinafter collectively known as “Image”) in connection with any legitimate purpose;
2. The right to use, reproduce, publish, exhibit, distribute, and transmit my or my minor child’s Image
individually or in conjunction with other images or printed matter in the production of brochures, internet/worldwide web, still photography, CD-ROM, and other media;
3. The right to record, reproduce, amplify and simulate my or my minor child’s Image;
4. The right to copyright, in its own name, works that contain my or my minor child’s Image; and
5. The right to assign the above-mentioned rights to third parties.
I hereby waive the right to inspect or approve my or my minor child’s Image or any finished materials that incorporate such Image. I understand and agree that I will receive no compensation, now or in the future, in connection with the use of such Image.
I hereby release and forever discharge Sandpiper Montessori Preschool from any and all claims, demand, rights, and causes of action of whatever kind that may arise from the use of my or my minor child’s Image, including all claims of libel and invasion of privacy.
I understand that publication may be accomplished electronically via the internet/worldwide web and that after publication Sandpiper Montessori Preschool will be unable to prevent persons from gaining access to the internet/worldwide web, copying my or my child’s image there from, and subsequently using, alerting, or republishing it without my consent.
Name of parent/legal guardian
Signature of parent/legal guardian: Checking this box is equal to your hand signature.
Name(s) of Minor Child
4927 Wrightsville Ave. Wilmington, NC 28403 ~ www.sandpipermontessori.org
For questions about enrollment, you may begin by filling out an application online, or e-mail Melissa Porter at firstname.lastname@example.org
Pick Up Authorization
Stretch and Grow Form
4927 Wrightsville Ave.
Wilmington, NC 28403