Secure Site Login

Adult Picture Release Form


The National Association for Amateur Radio
225 Main Street
Newington, CT 06111-1494

I, the undersigned, freely give to the ARRL, the American Radio Relay League, and their legal representatives, successors, and all persons, organizations, or corporations acting with their unrestricted permission to copyright and/or use, and/or publish photographic portraits or pictures of me, sounds, audio, and the negatives, transparencies, prints, videotapes, or digital information pertaining to them, in still, single, multiple, moving or video format, or in which I may be included in whole or in part or composite, or distorted in form, or reproductions thereof, in color or otherwise, made through any media in their studio, on websites or emails or elsewhere for art, or any other lawful purpose.

I hereby waive any right that I may have to inspect and approve the finished product or copy that may be used in connection with an image that the Photographer has taken of me, or the use to which it may be applied. I further release the Photographer, the ARRL or others for whom he/she is acting, from any claims for remuneration associated with any form of damage, foreseen or unforeseen, associated with the proper commercial or artistic use of these images unless it can be shown that said reproduction was intentionally maliciously caused, produced and published for the sole purpose of subjecting me to conspicuous ridicule, scandal, reproach, scorn and indignity. I acknowledge that the photography session was conducted during a routine amateur radio exercise, and this release was willingly signed. I certify that I am not a minor, and am free and able to give such consent.

Model's Name____________________________________ Callsign__________________
Model’s Phone (________) _____-___________________ Email ________________________________
Model's Signature __________________________________________________________
Event / Location ____________________________________________________________
Photographer Name ________________________________Callsign__________________
Photographer signature _______________________________________________________

Fax or Mail Copy with picture to:
Media and Public Relations Manager
225 Main Street
Newington, CT 06111-1494
Fax: (860) 594- 0259