USPS MODEL RELEASE FOR A MINOR

I, ______, (print parent or guardian’s name) do hereby give the Youth Activities Committee, a committee of the United States Power Squadrons, a North Carolina corporation, the irrevocable right to use the name of my child or ward, ______(print model’s name), picture, portrait or photograph in all forms for publication in the Ensign and/or on the websites of the United States Power Squadrons, without any restriction as to changes or alterations, for advertising, trade, promotion, exhibition or any other lawful purposes, and I waive any right to inspect or approve the photograph(s) or finished version(s) incorporating the photograph(s), including written copy that may be created and appear in connection therewith.

I hereby waive any claims on behalf of said child or ward they might otherwise have based on any usage of the photographs or works derived there from, specified above, including but not limited to, claims for either invasion of privacy or libel. I agree that this release shall be binding upon legal representatives, the heirs and assigns of the model and myself. I have read this release and am fully familiar with its contents.

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.

Dated:______

Parent or Guardian

Signature:______

Name: ______

Address: ______

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Witnessed by:

Signature:______

Name: ______

Address: ______

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PHOTOGRAPHER’S ASSIGNMENT OF COPYRIGHT

I, ______, the photographer of the photo(s) referred to herein, represent that I took the photograph(s) which is/are the subject of this assignment (copy attached) and hereby assign my right, title and interest in said photograph(s) to the United States Power Squadron for the copyright term.

Witnessed by: Photographer

Signature:______Signature:______Name:______Name: ______

Address: ______Address: ______

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