Chili Public Library Teen Photography Contest

Photo Release Form

Individuals over the age of 18 may sign for themselves. Anyone under 18 must have the release signed by their parent or legal guardian.

I hereby grant permission to the Chili Public Library to use photographs of my child/dependent/self in any official publicity pieces. Publicity pieces include (but are not limited to) news releases, publications, and web use. Names of the patrons may or may not be used with the photographs. I understand that signing this release does not mean that the photos will be used, but the Chili Public Library may use them on their website or other related websites, their newsletter, or publicity flyers.

Name of person in photo: (please print)____________________________________

If this person is under 18, name of parent or guardian__________________________

Address:_______________________________Phone:_______________________

City:_______________________________State:_______________ZIP:_________

Signature (self or parent/guardian):________________________________________
 

Chili Public Library welcomes people of all abilities to participate in our programs.  Please let us know if you will need any special accommodations.  We strive to make your library visit an enjoyable one!

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Chili Public Library, 3333 Chili Ave., Rochester, NY 14624    Tel. 585-889-2200