Photo Release Agreement Applicant: * (the "Participant") Today's Date: * Connecticut Community Foundation staff will regularly take photos during the Fall WCL program and subsequent alumni events. Although we hope you will allow us to use your image, it is not a requirement for participation in the program. Please select a checkbox below. Checkboxes Yes, I give permission to Connecticut Community Foundation to use my likeness in a photograph or video in any and all of its publications, including website entries, print media, press releases, annual reports, social media, advertising, e-mail marketing or any other purpose. I understand and agree that these materials will become the property of Connecticut Community Foundation and will not be returned. I hereby authorize Connecticut Community Foundation to edit, alter, copy, exhibit, publish or distribute my photo or video for purposes of publicizing the Connecticut Community Foundation’s programs or for any other lawful purpose. In addition, I waive the right to inspect or approve the finished product, including written or electronic copy. Additionally, I waive any right to royalties or other compensation arising or related to the use of the photograph. I hereby hold harmless and release and discharge Connecticut Community Foundation from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or on behalf of my estate have or may have by reason of this authorization. No, I do not give Connecticut Community Foundation permission to use my image. Electronic Signature of Participant: * Please type your full name in the box above to serve as your electronic signature. Email Address * Please enter your email address so a copy of your signed form can be mailed to you.