PLEASE NOTE:

If you have found an animal within the City of Steinbach, please call Rural Animal Management Services (RAMs) at 204-223-5521, the Steinbach City Hall at 204-326-9877, or the Steinbach Bylaw Officer at 204-346-6561.

Photo & Media Release for the Area Animal Rescue (SAAR)

[PLEASE PRINT THIS PAGE]

Participant’s Name: ______________________________________

Address: ________________________________________________

Phone Number: __________________________________________

Email Address: ___________________________________________

Date: ______________________

Description of Media: (e.g., photographs, video, audio recordings)

1. Consent and Release

I hereby grant Steinbach Animal Rescue and its representatives the right to take photographs, video recordings, and/or audio recordings of me, including my image, likeness, and voice, during my participation in and attendance at Steinbach Animal Rescue events and activities.

2. Use of Media

I agree that Steinbach Animal Rescue may use such photographs, videos, and audio recordings for any lawful purpose, including for publicity, illustration, advertising, and Web content.

3. Personal Information

I understand that my personal information, including my name, may be disclosed in connection with the media, unless stated otherwise:

☐ I consent to the disclosure of my name. ☐ I do not consent to the disclosure of my name.

4. No Compensation

I understand that I will not receive any financial compensation for the use of these images or recordings and hereby release Steinbach Animal Rescue and its representatives from any claims for remuneration associated with any form of damage, foreseen or unforeseen, associated with the use of the images or recordings.

5. Release and Indemnity

I hereby release and forever discharge Steinbach Animal Rescue from any and all claims, demands, rights, promises, damages, and liabilities arising out of or in connection with the use or distribution of said photographs and/or video and audio recordings, including but not limited to any claims for invasion of privacy, appropriation of likeness, or defamation.

6. Understanding and Agreement

I have read this release before signing below and I fully understand the contents, meaning, and impact of this release. I understand that I am free to address any specific questions regarding this release by submitting those questions in writing prior to signing, and I agree that my failure to do so will be interpreted as a free and knowledgeable acceptance of the terms of this release.

Signature: ________________________________________

Date: ______________________

If the Participant is under the age of 18:

As the parent/legal guardian of the minor named above, I hereby give my permission for Steinbach Animal Rescue to use the minor’s image as described above.

Parent/Guardian’s Name: _______________________________

Signature: ____________________________________________

Date: ______________________

 

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