AUTHORIZATION AND RELEASE FOR USE OF PHOTOGRAPHIC IMAGES AND VIDEO(Required)I hereby grant to Becca Williams International, LLC and its agents, officials, representatives, or assigned agencies, including officers, employees, or related personnel both individually and collectively (the “Released Party”) the absolute and irrevocable right and unrestricted permission in respect of photographic portraits, videos or pictures that the Released Party had taken of me (the “Photographic Images”), whether individually or together with one another and/or other individuals and the content of any verbal or written statements made by me and used in connection with such Photographic Images, in the name of the Released Party or otherwise. I further grant to Becca Williams International, LLC the absolute and irrevocable right to use, re-use, publish and re-publish the Photographic Images in whole or in part, individually or in conjunction with other photographic images, and in art, editorials, advertising and trade, or any other purpose whatsoever including, without limitation, the promotion of any websites or brands owned or operated by the Released Party without restriction as to alteration; by any medium or channel including but not limited to television, radio, newspaper or other periodical, Internet, or any other means whether electronic or otherwise; and to use my name, location, profession, and/or any other identifying or potentially identifying information in connection therewith if the Released Party so chooses. I hereby release and discharge the Released Party from any and all claims and demands arising out of or in connection with the use of the Photographic Images, including without limitation any and all claims for libel, invasion of privacy, or false light, and from any and all liability for damages of whatever kind, which may, at any time, result to me, my heirs, legal representatives, and assigns because of compliance with this Authorization and Release. This Authorization and Release shall also inure to the benefit of the heirs, legal representatives, licensees, and assigns of the Photographer, as well as the persons for whom s/he took the Photographic Images. I have read the foregoing and fully understand the contents thereof. This Authorization and Release shall be binding upon me, my heirs, legal representatives, and assigns. AgreeIn photographs and/or video (check one):(Required) Show my first name only Show my first and last name Don’t show name Date(Required)MonthMonth123456789101112DayDay12345678910111213141516171819202122232425262728293031YearYear2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Email(Required) Name(Required) First Last Electronic Signature(Required)Type your name to agree to the terms above.NameThis field is for validation purposes and should be left unchanged.
