Gallery-Shows.com Photographer Release Form

I hereby give Gallery-Shows.com, its successors and assigns, the absolute right and permission to publish, post on the Internet, modify and/or use the Entry in whole or in part, in conjunction with my own or a fictitious name, with reproduction thereof in color or otherwise, made through any media at its office or elsewhere, for art, advertising trade or any other lawful purpose whatsoever. I hereby release, discharge, and agree to save Gallery-Shows.com, its successors, officers, directors, employees, and agents from any liability in connection with the publication of any photograph or information pertaining to me. I hereby waive any right that I may have to inspect and/or approve the finished product and printed matter that may be used in connection therewith, or the use to which it may be applied. I hereby represent that I am over the age of 18 years and I have read this authorization and release prior to its execution. I declare under penalty of perjury that the foregoing is true and correct.

WARNING: ANYONE SIGNING THIS RELEASE FORM OTHER THAN THE PHOTOGRAPHER WILL BE SUBJECT TO MONETARY DAMAGES AND/OR CRIMINAL PROSECUTION. I DECLARE UNDER PENALTY OF PERJURY THAT ALL OF THE ABOVE INFORMATION I HAVE GIVEN ABOVE IS TRUE AND CORRECT.

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NAME:                                        DATE:

Name:        _______________________________________________________
Company:  _______________________________________________________
Address:    _______________________________________________________
City:           _______________________________________________________
State:         _______________________________________________________
Zip:             _______________________________________________________
Telephone: _______________________________________________________

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Gallery-Shows.com
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Brandon, Florida 33509-3707

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