Photo Release and Assignment of Copyright

The undersigned (or for a person under the age of eighteen (18) years, the parent or guardian) hereby agrees and consents to the following:

1. The Corporation of the Municipality of Leamington, (the “Municipality”), is hereby permitted to photograph or otherwise record my image.
2. I hereby transfer to the Municipality the right to reproduce my image for the purpose of promoting the Municipality of Leamington, (“Leamington”), and activities associated with Leamington. My image may be reproduced in any medium or format including websites, promotional literature, promotional videos, and promotional items.
3. The said transfer by me includes all copyrights in perpetuity in the said image for use by the Municipality in any medium or format.
4. I hereby waive any compensation, royalties or claims thereto with respect to the recording of my image or its future reproduction by the Municipality.
5. I acknowledge that the Municipality, together with others, may reproduce, distribute and make use of my image for the purpose of promoting Leamington.
6. I hereby waive any claims against the Municipality, or anyone acting on behalf of the Municipality, in respect to the recording, reproduction, distribution or use made by the Municipality of my image.

For persons under the age of eighteen (18) years of age, this release and assignment may be signed by a parent or guardian.

Privacy Statement:  Personal information on this form is collected under the authority of the Municipal Act, 2001 P.S.O. c.45, and will be used to administer its Photo Release and Assignment of Copyright form. Questions about the collection of this information can be directed to the Manager of Legislative Services/Clerk, Municipality of Leamington, 111 Erie Street North, Leamington, N8H 2Z9, Telephone: 519-326-5761.