Updated 1/7/13<strong>Chesapeake</strong> <strong>Swim</strong> <strong>Club</strong> Photo and Video recording RELEASE FORM From time to time photographs, videos, and/or audio clips may be taken of the <strong>Chesapeake</strong> <strong>Swim</strong> <strong>Club</strong> [CSC]swimmers and used in our newsletters, on our website, or in other promotional or informational materials. CSCrequests the right to use all photos, videos, and/or audio clips taken of CSC swimmers.I hereby give <strong>Chesapeake</strong> <strong>Swim</strong> <strong>Club</strong> [CSC] permission to take photographs of the minor named below or photographs inwhich the minor may be involved with others for the purpose of promoting CSC. These purposes may include but are notlimited to promotional materials for the team (brochures, ads, bulletin boards, etc) as well as publication on the CSCwebsite or in a team newsletter.I hereby release and discharge the <strong>Chesapeake</strong> <strong>Swim</strong> <strong>Club</strong> from any and all claims arising out of use of the photos, or anyrights that I or the minor may have. Photos may be used for promotional purposes, advertising and other print materials atthe discretion of CSC Board of Directors and/or the CSC Head Coach/CEO. I understand that I will not be compensatedfor the use of any photographs or video recordings.Consistent with the permission granted above, CSC may reproduce, copyright, publish, circulate, and otherwise use thephotos or recording of my swimmer, whether taken in a studio or elsewhere, in black-and-white or in color, alone or inconjunction with other persons or characters real or imaginary, in any part of the world. I hereby waive the opportunity orright to inspect and/or approve the finished recordings or the use to which they may be put consistent with thisAuthorization.In exchange for good and valuable consideration, I hereby grant to CSC all right, title, and interest in and to all negatives,prints, tapes, and reproductions thereof, if any, and I hereby release CSC and its successors and assigns, if any, from anyand all rights claims, demands, actions, or suits which I may or can have against them on account of the use or publicationof the recordings.This release is effective until terminated by a retraction in writing from the person granting this authorizationI, the parent/legal guardian of, _______________________________________________________________(swimmer), Do Do not {please mark one}grant my expressed permission for CSC to use photographs or video recordings for my swimmer as described above. Icertify that I am a custodial parent and have the aforementioned rights to assign. I have read and understand the releasestated above and hereby agree to its terms and conditions.Parent/Guarding name: {please print clearly}________________________________________________________________________Signature: _______________________________________________________________ Date: _______________<strong>Swim</strong>mer’s Name: _________________________________________________________<strong>Swim</strong>mer’s Signature if age 18 or over: ________________________________________ Date: _______________16
17Updated 1/7/13