RELEASE FORM Thank you for your contribution. Question Title * 1. I, do hereby give Wings for Justice, its assigns, licenses, and legal representatives the irrevocable right to use my name, picture, portrait, or photograph in all forms and media and in all manners, including composite or distorted representations, for advertising, trade, or any other lawful purposes, and I waive any right to inspect or approve the finished version(s), including written copy that may be created in connection therewith. I am of full age. I have read this release and am fully aware of its contents. Question Title * 2. Consent Date (month/day/year) * Name Address City * State * ZIP * Phone Email * Witness Contact Question Title * 3. Parent or Guardian Consent (if applicable)I am the parent or guardian of the minor named above, and have the legal authority to execute the above release. Date (month/day/year) Parent or Guardian Address City State ZIP Phone Email Witness Contact Question Title * 4. I am the parent or guardian of the minor named above, and have the legal authority to execute the above release. I approve the foregoing and waive any rights in the premises. Question Title * 5. Wings for Justice's Terms of Service and Privacy Policy. We have read and agree to the terms of service and online privacy policy. Thank you. You are making a difference.
