PHOTO RELEASE FORM
*IF PERSON IS UNDER THE AGE OF JURISDICTION, PLEASE HAVE LEGAL GUARDIAN COMPLETE THE INFORMATION AND CHECK THE BOX ON THE SIGN UP FORM.
I acknowledge and understand that by providing my information I am giving permission to 7-Eleven Canada to use my photo(s).I agree to allow 7-Eleven the right and license to attribute the photo or video (if any) I personally submitted, of me or by my name and to use any such photo or video (including, where applicable, my likeness as it appears in such photo), as well as my name, likeness and city of residence, including, where applicable, my likeness as it appears in submitted photo for any purpose, in any advertising and publicity in relation to any other present or future advertising and publicity for 7-Eleven.I hereby release 7-Eleven Canada, Inc. (“7-Eleven”) and its subsidiaries, affiliates, employees, directors, officers, suppliers, agents, sponsors and administrators (collectively, “Releases”) from any and all liability for any loss, harm, damages, cost or expense arising out of the event and any, activities arising from the event , including, without limitation, costs, injuries and losses related to personal injuries, death, damage to, loss or destruction of property, rights of publicity or privacy, defamation, or portrayal in a false light, or from any and all claims of third parties arising therefrom.
I hereby irrevocably authorize 7-Eleven Canada, and its supplier agencies, to publish, display, broadcast, reproduce, modify, edit, distribute and /or use in any manner which they or either of them in their discretion deem advisable, any video tape (includes all edits), film, likeness of me as it appears or is presented and /or my voice is recorded on camera and which is produced, prepared or written with my consent and I release, remiss and forever discharge the noted advertising agency, client and / or its principals from and in respect of all claim , demands, damages, publicity rights, defamation, invasion of privacy, copyright infringement, trade mark infringement, or other intellectual property related and causes of action rising from or connected with the publication, broadcasting, distribution and/or other use of any of the aforesaid mediums of advertising.
I confirm, represent and warrant that:
(i) I have received, read, understood and complied with the information above;
(iii) I am not an employee or agent of 7-Eleven; and
(iv) I have carefully read all of the foregoing, I fully understand its contents and I have given this release, discharge and declaration of my own free will.