This form MUST be completed if any of your photo entries contain recognizable faces. Any photos containing recognizable faces without a complete Model Release Form will be DISQUALIFIED. This form can also be found within the 2026 Photo Contest Entry Form and as a PDF on our website. Hard copies can be picked up at the Albany Visitors Association office.

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* Photographer:

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* Location of photo:

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* Date of photo:

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Address: c/o Albany Visitors Association, 122 Ferry St SW, Albany, OR 97321

For consideration which I acknowledge, I irrevocably grant to the Photographer and their assigns,
licensees, and successors, the right to use my image and name in all forms and media, including
composite or modified representations for all purposes, including advertising, trade, or any commercial use
purpose throughout the world and in perpetuity. I waive the right to inspect or approve versions of my
image used for publication, or the written copy that may be used in connection with the images.

I release the Photographer and its assigns, licensees, and successors from any claims that may arise
regarding the use of my image, including any claims of defamation, invasion of privacy, or infringement
of moral rights, rights of publicity, or copyright. The Photographer is permitted, although not obligated,
to include my name as a credit in connection with the image.

The Photographer is not obligated to utilize any of the rights granted in this Agreement.
I have read and understood this agreement, and I am over the age of 18. This Agreement expresses the
complete understanding of the parties.

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* Model(s)

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* Address/Contact Information

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* If the person signing is under 18, consent should be given by a parent or guardian as follows. I hereby certify that I am the parent or guardian of:

The model names above, and for values received, I do give my consent without reservations to the
foregoing on behalf of him or her or them.

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* Notes/Exceptions:

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* Signature of Model or Signature of Parent or Guardian:

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* I acknowledge that by entering my name above I am providing a digital signature.

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* Date:

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