Photo Release for JSSI 2018
Please fill out one photo release for each adult and corresponding children, if applicable.
Email address *
I hereby grant permission to the Japan Seattle Suzuki Institute to use my likeness and the likeness of my child/children in a photograph, video, or other digital media (“photo”) in any and all of its publications, including web-based publications, without payment or other consideration. I understand and agree that all photos will become the property of the Japan Seattle Suzuki Institute and will not be returned.I hereby irrevocably authorize the Japan Seattle Suzuki Institute to edit, alter, copy, exhibit, publish, or distribute these photos for any lawful purpose. In addition, I waive any right to inspect or approve the finished product wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of the photo. I hereby hold harmless, release, and forever discharge the Japan Seattle Suzuki Institute from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or on behalf of my estate have or may have by reason of this authorization. I HAVE READ AND UNDERSTAND THE ABOVE PHOTO RELEASE. I AFFIRM THAT I AM AT LEAST 18 YEARS OF AGE. *
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Digital signature: I agree that the entry of my name herein and submission of this form shall be as valid as my signature by hand. * (Write your name below.) *
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Date signed: *
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If you are the parent or legal guardian of any JSSI participants, please type the full name of your child/ren below. *
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