Photo Release

NJAEMSE Photo Release Form

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Name *

First

Last

Email *

I hereby grant the NJ Association of EMS Educators permission to use my likeness 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 NJ Association of EMS Educators and will not be returned.
I hereby irrevocably authorize the NJ Association of EMS Educators 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 NJ Association of EMS Educators 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:

Full Name As Signature *

TODAY'S DATE *

Check here if you do not wish to be photographed. If selected, please speak to a NJAEMSE Board Member about appropriate seating. *

NO PHOTOGRAPHS

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