GSA Network Photo Release Form
Program Name and Date:
By selecting yes, you hereby authorize GSA Network to reproduce your image, photograph or to be filmed, as part of this program, for publicity and fundraising purposes. Their photograph, image, or likeness may appear in either official materials including (but not limited to) brochures, websites, email blasts, or any other form of media and/or technology currently in existence or not yet developed. I understand that my/my child’s pictures and/or interview may be accessible to anyone with Internet access and may appear in local, statewide, national, and international print or television media.
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Your legal name
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Document Name: GSA Network Photo Release Form
Agree & Sign