Media Release Form
Thank you for Volunteering with Agua International Water Relief. As is common practice with many nonprofit organizations, Agua International Water Relief periodically produces print, audiovisual materials, and/or publishes such materials online so that a broader audience can learn about our work. Thus, Agua International Water Relief and its authors, producers, editors and other personnel request your kind permission to illustrate, photograph, record and/or video tape your likeness, voice and/or personal identification.

Please know that Agua International Water Relief will not sell for a profit print or audiovisual materials that incorporate you, your likeness, voice, and/or personal identification. As mentioned above, these materials will be used solely to advance the mission of Agua International Water Relief as a nonprofit organization. You will also retain the right to use your likeness, voice, and/or personal identification that appear in our print or audiovisual materials.

By signing this document, you release Agua International Water Relief, the author(s), producer(s), editor(s) and related personnel from any and all claims in the usage of your likeness, voice and/or personal identification, as incorporated and edited into material including, but not limited to, digital media, advertising, promotion, press releases, video tapes, books and/or other printed material.

By signing this release, you also understand that Agua International Water Relief is unable to provide you with financial or other remuneration for recording your likeness and/or voice, either for initial or subsequent usage, and that Agua International Water Relief is not responsible for any expense or liability incurred as a result of your participation in such recording, including medical expenses due to any sickness or injury incurred as a result.

I agree with the above provision and hereby grant to Agua International Water Relief permission as requested above.

If volunteer is under 18 years of age, parent or guardian must read and sign the following:
This release, its significance, and assumption of risk have been explained to and are understood by the minor.
Do you agree with all of the above? *
Required
Electronic Signature Agreement. By checking the "I Accept" box below, you are signing this Agreement electronically. You agree your electronic signature is the legal equivalent of your manual signature on this Agreement. *
Required
By checking the "I Agree" box below and typing in your name you consent to be legally bound by this Agreement's terms and conditions. *
First Name *
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Last Name *
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Date *
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If volunteer is under 18 years of age, parent or guardian must read and the following: This release, its significance, and assumption of risk have been explained to and are understood by the minor. If you agree then please sign your name by typing it below:
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Contact Email *
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Contact Phone Number *
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