Fearless Phil Photo Release Form

Add Your Photo or Video to Our Website

Take a photo or video of you or your child reading Fearless Phil and upload it to our landing page. 😍

MEDIA RELEASE WAIVER

By signing this, I hereby grant permission to Live Long Productions, Life Long Publishing, Live with Impact (collectively referred to as "the Organizations"), and their agents to use photographs of me and/or my child, taken in the context of reading the children's book "Fearless Phil" (the "Photographs") on the Organization's website and for marketing purposes.

I confirm that I am at least 18 years of age and have full legal authority to grant this permission. If I am granting this permission on behalf of a minor child, I confirm that I am the legal guardian of the child and have the authority to do so.

I understand that the Organizations may use the Photographs for promotional and marketing materials, including but not limited to the Organizations' website, social media accounts, printed materials, and other promotional channels. I agree that the Photographs may be used without any further compensation or notification to me or my child.

I understand that once the Photographs are posted on the Organization's website, they may be viewed and downloaded by other website users, and the Organizations cannot control or monitor their subsequent use by third parties.

I release and discharge the Organizations and their agents from any and all claims, demands, actions, causes of action, or liability of any kind arising from or related to the use of the Photographs.

I have read and understood this release before agreeing to it, and I am fully informed about the content and purpose of this release.

First Name - (I am 18 or Older)

Last Name

Name of Child in Photo (if applicable)

Last Name

Is there more than one child in the photo?

Yes

Names are for legal purposes only and will not be shared, sold, or published with photos.

First Name - ( Child 2 in photo)

Last Name

First Name - ( Child 3 in photo)

Last Name

First Name - ( Child 4 in photo)

Last Name

First Name - ( Child 5 in photo)

Last Name

First Name - ( Child 6 in photo)

Last Name

First Name - ( Child 7 in photo)

Last Name

First Name - ( Child 8 in photo)

Last Name

First Name - ( Child 9 in photo)

Last Name

First Name - ( Child 10 in photo)

Last Name

Image or Video Upload

Choose File

Image or Video Upload

Choose File

Image or Video Upload

Choose File

I am the Adult in the photo or the Parent/Guardian (if signing on behalf of a child):

Yes

Date / Time

Signature

Sign Here

Email Me (Optional)

Yes - a copy of this waiver

Yes - Anything is Possible games, quizzes and freebies

No - don't email me

Email (Optional)