Image Release Consent Form
(ADULT)
Being of legal age, I hereby consent:
- That the photographs, audio/videotapes, electronic images and/or other works in which I appear or am depicted, may be used by The DeVan Group®, 9701 Apollo Dr. Largo, Maryland, USA, and its agents for outlets including but not limited to TDG Creative Book Writing Project, television, newsletters, newspapers, internet, publications, and advertisements without limitation; and
- To release all my rights to the aforementioned and allow it to become The DeVan Group® property so that they shall have the right to publish, reproduce, distribute and make other uses free of all claims and/or damages that I may incur.
Signature of Contributing Author
[PRINT NAME]
Date
Signature of The DeVan Group® Signee
[PRINT NAME]
Date
Contributing Author Contact Info:
Email Address and/or Phone number
Mailing Address
City/State/Zip
PLEASE RETURN COMPLETED FORM TO:
The DeVan Group, LLC
9701 Apollo Dr., Suite 100
Largo, MD 20774, USA
PHONE: 240-232-6105
FAX: 301-542-0192
The DeVan Group, LLC
9701 Apollo Dr., Suite 100
Largo, MD 20774, USA
PHONE: 240-232-6105
FAX: 301-542-0192