Photograph/Video Student Authorization and Release Form

The Society for Science is the non-profit organization that provides the Science News Learning program to teachers around the world. Your child's teacher is part of this program. To share educational resources among teachers in the program, and to attract additional participants and funders, the Society and its sponsors wish to use engaging photographs to convey the benefits of the program. These photographs may include images of your child in print and online publications and listings, as well as your child’s school name, teacher/mentor’s name, city and state. We seek your permission for this use. If you have any questions, please contact apawlow@societyforscience.org. 

I grant Society for Science and its partner organizations (including but not limited to Regeneron) and their respective agents, representative, affiliates, and assignees permission to use my child's image/likeness, and biographical information (including school name, teacher’s name, city and state) for promotional and advertising purposes in any manner (including print and online written materials and social media postings). I acknowledge and agree that I will have no right of approval, no claim to any compensation, and no claim arising out of the use of my child’s name, image/likeness, and biographical information in connection with the exercise of the rights granted under this release.

Undersigned hereby releases and discharges the Society and its employees, agents, designees, and/or sponsors, from any and all claims and demands arising out of or in connection with the use of undersigned’s photograph, likeness or image, including without limitation any and all claims for libel, invasion of privacy, violation of the right of publicity, or violation of copyright ownership. Undersigned hereby waives any right of inspection or approval of the use of undersigned’s photograph, likeness or image.

Undersigned acknowledges that undersigned is not receiving any compensation for the photograph, likeness or image, and undersigned releases all claims against the Society and its employees, agents, designees, and/or sponsors, for compensation related to the use of undersigned’s photograph, likeness or image.

Undersigned acknowledges that the terms of this General Authorization and Release have been completely read, are fully understood and voluntarily accepted. This General Authorization and Release shall be binding upon undersigned and the heirs, legal representatives, and assigns of undersigned. The laws of the District of Columbia shall govern the terms of this General Authorization and Release.