Please read the following and fill out the form below.
1. Subject Matter
For good and valuable consideration herein acknowledged, an upon the terms hereinafter stated, I, hereby grant to Southland Credit Union, its affiliate entities, employees, agents and assigns, the unconditional right and permission to photograph or otherwise record or document my likeness (hereinafter “image”) and/or to and use or publish any images of me or in which I may be included obtained, including any images(s) obtained from any outside source, in whole or in part, without restriction, from time to time.
2. Use
Said image(s) may be used or published in conjunction with my own or a fictitious name, in color or otherwise, in composite or individually, regardless of any change or alteration, through any media, for purposes of art, advertising, trade, or any other purpose whatsoever. I consent to the use of any product(s) or printed matter in conjunction therewith. I hereby waive any right that I may have to inspect or approve the finished product(s) or printed matter that may be used in conjunction therewith or the use of which it may be applied.
3. Ownership
To the extent that I possess any ownership interest in said image(s), I further grant Southland Credit Union all exclusive rights, title, copyright and ownership in same. I further waive my rights to privacy regarding such images or use thereof.
4. Release and Indemnification
I hereby release, discharge and agree to indemnify and hold Southland Credit Union harmless, including any person or entity acting under the permission or authority of Southland Credit Union or for whom Southland Credit Union is acting, from any liability whatsoever associated with the use or publication of said image(s). I further waive any and all claims arising from any change or alteration to my Image(s), including any blurring, distortion, alteration, optical illusion, electronic alteration, or use in composite form, whether intentional or otherwise, even though it may subject me to ridicule, scandal, reproach, scorn and indignity. I further waive any and all compensation.