Photo/Video Authorization and Release 

I, _______________________________, of _____________________________________ 

__________________________________in consideration of my engagement as a model, authorize Connected Canadians (the ‘Photographer’), to use: 

1. Film photographs 2. Digital photographs 3. Motion picture footage 4. Audio recordings 

of me (the ‘Materials’) to help promote Connected Canadians and its services. Connected Canadians is a non-profit organization with a mandate for digital literacy for seniors and older adults, and provides free technology training for seniors and older adults. 

REPRODUCTION AND USE 

Connected Canadians has the unrestricted right and permission to copyright and use, re-use, publish, and republish the Materials in all forms of media (including printed materials) for art, promotional purposes (including, but not limited to, advertising, publicity, commercial, or display use), illustration, exhibition, editorial, trade, or any other purpose whatsoever. This right extends to both domestic and foreign markets. 

RELEASE OF CLAIMS 

I hereby relinquish any right that I may have to examine or approve the completed Materials or their use(s). 

Further, I hereby release and discharge Connected Canadians and all persons functioning under his/her permission or authority (including, but not limited to, associates, affiliates, officers, agents, advertising agencies, designated directors, employees, and customers) from any claims. This includes claims related to blurring, alteration, distortion, or use in composite form that may occur or be produced in the process of recording, processing, or publishing the Materials, including any claims for libel or invasion of privacy. 

I hereby affirm that I am over the age of majority and have the right to contract in my own name. I have read the above document and I fully understand its contents. This agreement shall be binding upon me and my heirs, legal representatives and assigns. 

Dated: __________________________________ 

Signed: __________________________________