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Photo Release for person over 18 years of age.

I hereby grant the right to The Arc of Pennsylvania and to its employees, affiliates, and consultants to create, copy, reproduce, exhibit, publish, or distribute any likeness of myself to be used for the purposed of promoting The Arc of PA’s mission of enhancing the rights of people with disabilities. I understand that the above uses may include, but are not limited to video recordings, films, sound recordings, photographs, displays, brochures, websites, multi-media programs, or any other type of promotional medium existing now or in the future. I further understand that by granting this permission I am irrevocably giving up all rights and claims to monetary compensation for any future uses of this material by the above persons & organizations.
Contact Information
Country
Address Line 1
City
State
Postal Code
I am witnessing or giving consent on behalf of the above individual and my contact information is as follows::
First Name
Last Name
Country
Address Line 1
City
State
Postal Code

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