Photo Release and Waiver Form I give permission for The Statewide Independent Living Council (SILC) of Alaska to use photographs/video/excerpts of essay/written testimony of myself to promote Alaska Youth Leadership and Engagement Initiatives. This may be in the form of brochures, posters, promotional videos, multimedia, web media, social media, or academic or promotional presentations. Furthermore, I release and hold the SILC of Alaska, and any other partners, harmless from any liability from any act or omission, which arises from the use of the photographs/videos/written materials. In addition, I waive any proprietary interest in the photographs/videos/written materials or any benefits whatsoever occurring to Alaska Youth Leadership and Engagement Initiatives and the SILC of Alaska from their use. By Signing below, I, the legally responsible party for this Participant, certify that I have carefully read, fully understand, and agree with this statement and its contents.Applicant Name(Required) First Last Date(Required) MM slash DD slash YYYY Email(Required) Participant Digital Signature(Required)By signing your name electronically, you are agreeing that your electronic signature is the legal equivalent of your manual signature on this form. You will receive a copy of this form. Parent/Guardian Name First Last Parent/Guardian Email Parent/Guardian Phone #Parent/Guardian Signature (if applicable):By signing your name electronically, you are agreeing that your electronic signature is the legal equivalent of your manual signature on this form. You will receive a copy of this form. Δ
