Photographer and Model Release
Instructions: Mail a copy of your photograph to UtahDiving.com with this form. Photos will not be returned. Both the photographer and any individuals appearing in the picture must give permission to display the photo.
| Photo title (if any): |
| Date of picture: Location picture was taken: |
| Photographer: |
| Names of persons or animals in picture (left to right): |
| Description of situation: |
| Equipment used: |
Photographer release: As the owner (copyright holder) of this
photograph, I give permission for UtahDiving.com to use, display, or distribute this photo
in any form. I retain the right to withdraw permission with 30 days written notice.
__________________________ ____________
Signature
Date
Model release: I have reviewed the photograph of me and I understand
that it will be displayed on the internet. I give permission UtahDiving.com permission to
use, display, or distribute this photo in any form.
__________________________ ____________
Signature
Date
__________________________ ____________
Signature
Date
Please mail your picture and this form to:
UtahDiving.com
c/o Mad Scientist Software
115 N. 200 W., 2nd Floor
Alpine, UT 84004
Phone: 801-756-6027
Fax: 801-763-9925