Model/Artist/Release

Name *

First Name

Last Name

Are you a Rochester, NY Resident? *

Yes

No

I am 18 or older *

You must be 18 or older

Yes

Phone *

(###)

###

####

Non-Disclosure. The Recipient agrees that it shall have the obligation to: (a) hold any Confidential Information in the strictest of confidence; (b) not use the Confidential Information for any personal gain or detrimentally to the Releasor; (c) take all steps necessary to protect the Confidential Information from disclosure and to implement internal procedures to guard against such disclosure; (d) not disclose the fact that the Confidential Information has been made available or that discussions and negotiations are taking place or have taken place or any of its terms, conditions or other facts with respect to the transaction; and (e) not disclose or make available all or any part of the Confidential Information to any person, firm, corporation, association, or any other entity for any reason or purpose whatsoever, directly or indirectly, unless and until such Confidential Information becomes publicly available other than as a consequence of the breach by the Recipient of their confidentiality obligations hereunder *

Non-Disclosure. The Recipient agrees that they shall have the obligation to: (a) hold any Confidential Information in the strictest of confidence; (b) not use the Confidential Information for any personal gain or detrimentally to the Releasor; (c) take all steps necessary to protect the Confidential Information from disclosure and to implement internal procedures to guard against such disclosure; (d) not disclose the fact that the Confidential Information has been made available or that discussions and negotiations are taking place or have taken place or any of its terms, conditions or other facts with respect to the transaction; and (e) not disclose or make available all or any part of the Confidential Information to any person, firm, corporation, association, or any other entity for any reason or purpose whatsoever, directly or indirectly, unless and until such Confidential Information becomes publicly available other than as a consequence of the breach by the Recipient of their confidentiality obligations hereunder.

Agree

Disagree

ELECTRONIC CONSENT: You must Agree to Participate: I give to Rochester Artist Collaborative, its nominees, agents, and assigns, unlimited permission to use, publish, and republish, for purposes of advertising and trade and for such use as it may determine, information and reproductions of my likeness.I hereby grant Rochester Artist Collaborative unlimited rights and usage of my comments, image(s), name and any other applicable information in news releases, feature articles, advertisements, web and social media communications, videos, marketing and communications materials, and other promotional efforts as well as publication in general and trade magazines, newspapers and other printed or electronic publications. I understand and accept that the use of this information has no expiration date and may be used at any time without subsequent contact or approval. *

1. By submitting this form, you agree to no compensation or payment, allow Adam Eaton and Rochester Artist Collaborative ownership of all photographs and/or video, and assign copyright to their organization. You acknowledge that use of the photographs may be granted. I have read this form carefully and fully understand the implications. I am 18 years old or over. You must Agree to Participate: I give to Rochester Artist Collaborative, its nominees, agents, and assigns unlimited permission to use, sell, publish, and republish, for purposes of advertising and trade and for such use as it may determine, information and reproductions of my likeness. I hereby grant Rochester Artist Collaborative unlimited rights and usage of my comments, image(s), name and any other applicable information in news releases, feature articles, advertisements, web and social media communications, videos, marketing and communications materials, and other promotional efforts as well as publication in general and trade magazines, newspapers and other printed or electronic publications. I understand and accept that the use of this information has no expiration date and may be used at any time without subsequent contact or approval. Clicking on the "Agree" button below indicates that you have read the above information, you voluntarily agree to participate.

Agree

Disagree

You agree that any Media created by Rochester Artist Collaborative and it's photographers or videographers posted to Social Media will be tagged and credited to Rochester Artist Collaborative. *

Agree

Disagree