I, _________________________(print name), hereby give The CCDMD / CCCVB / BridgeWalkcc.com and CorpusChristiFirst.com, its representatives and employees, the absolute right and permission to publish, copyright and use pictures of me in which I may be included in whole or in part, composite or retouched in character or form, for any lawful purpose, including for example such purposes as publicity, illustration, and Web content. Such use is permitted in conjunction with the use of (initial all those applicable):
________________my own name
________________a fictitious name
________________no name to be used
Date:_____________________________________
Name:____________________________________
Address:__________________________________
Phone: ____________________________________
Signature:__________________________________
If the person photographed is under 18, please complete the following, in addition to the above:
I certify that I am his or her parent or legal guardian and I give my consent without reservation to the foregoing on his or her behalf.
Date:_____________________________________
Name:____________________________________
Address:__________________________________
Phone: ____________________________________
Signature:__________________________________