Meridies Photographer Release Form

Request edit access

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

This form may be completed and e-mailed to an SCA publication for immediate use. SCA publications must have your signature on file to use your material. This signature can be digital in the form of an email from you stating that you agree to the terms of this release.

Once this form is completed, you will receive an email with the content of the form. Releases based on this form are not in effect until it has been forwarded as an email (with the body of the email stating "I agree to this form") to ksmo@meridies.org and you have received confirmation of receipt. This will count as a signature for legal purposes.

My Legal Name is: *

I am known in the Society for Creative Anachronism as *

Do hereby agree to the following with respect to my photograph(s) (hereinafter “the Photograph”) entitled:

only answer if you only want to give a release for one specific item

GRANTS OF USE *

The SCA may (check all that apply):

1. Publish the Photograph once in an issue of Pop Chiv

2. Publish the Photograph no more than ____ times in the above publication [Please answer in the next section];

3. Publish the Photograph along with the article entitled_____[Please answer in the next section]

4. Publish the Photograph with any article or as a stand-alone picture in any SCA publication;

5. Publish the Photograph on a SCA web site for ____ [Please answer in the next section]

6. Publish the Photograph on any SCA web site or similar media.

PERPETUAL GRANTS OF USE(Please select I agree in the appropriate section below)

Required

(If you selected 2, 3, or 5: number of times to be published OR event name

If 2: If it can be reproduced in perpetuity, please put "no limit" in this field.

PERPETUAL GRANTS OF USE

I agree that the Photograph(s) identified above, as well as any photos I submit to the SCA at any time in the future, may be used for any of the Grants of Use set out above, whether I have checked them or not.

I agree

I agree, represent and warrant that:
1. I am the owner of the Photograph.
2. That all of the grants of use I have given above include the right of the SCA to publish my photo in
any re-print of a publication including electronic media.

I agree to indemnify and hold harmless the SCA in the event any claim is brought against the SCA by any person claiming that they have any right, title or interest in the Photograph superior to mine or that I did not have lawful authority to grant the above permission and rights to the SCA.

I understand that I have the right to withdraw permission at anytime through written communication to ksmo@meridies.org

Today's date is *

YYYY

By writing my name in the following text box, I agree to the terms of the waiver above. *

My mailing address is *

My email address is *

I acknowledge that I will receive an email with the content of this form and will forward it to the Kingdom Social Media Officer. Releases based on this form are not in effect until it has been forwarded as an email to ksmo@meridies.org and I have received confirmation of receipt. This will count as my signature for legal purposes. *

I agree.

Required

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Forms