RELEASE FORM I hereby assign and grant to the Red Hat Society

RELEASE FORM
I hereby assign and grant to the Red Hat Society all my rights related to, and permission
to use and publish, any photographs, films, video tapes, electronic representations,
written materials and or sound recordings provided by me or taken of me at the Red Hat
Society, Chapter or member events or activities. I hereby release the Red Hat Society
from any and all liability from such use and publication.
I hereby authorize the reproduction, sale, copyright, exhibit, broadcast, electronic storage
and/or distribution of such photographs, films, video tapes, electronic representations,
written materials and sound recordings at the discretion of Red Hat Society. I will not
receive any payment for such use and I specifically waive any right or claim I may have
with respect to any of the foregoing.
I understand that these photographs, films, video tapes, electronic representations, written
materials and or sound recordings will become the property of the Red Hat Society and
may be used by or to promote the Red Hat Society now or at any time in the future,
forever and throughout the world in any manner and/ or medium including, without
limitation in the advertisement and promotion of the Red Hat Society and its products and
services.
NAME:_____________________________________
SIGNATURE: __________________________________
CHAPTER____________________________________
ADDRESS:___________________________________
CITY, STATE ZIP______________________________
PHONE NUMBER:_______________________________
DATE:_______________________________________