Quivira's Photo Release Quivira Coalition Photo Release and Authorization Name(Required) First Last Email(Required) Enter Email Confirm Email Organization Social Media HandlesList the places where you would like to be tagged if we use your photos Photo Release Consent (Photos submitted by you)(Required)I grant permission for Quivira Coalition to use the images submitted for its communications purposes at Quivira’s discretion. Quivira Coalition, and others with Quivira’s consent, have non-exclusive rights to use and publish the photograph(s) submitted for use on the website and social media pages, or in publications such as (but not limited to) newsletters, annual reports, brochures, conference materials, postcards, slideshows and press releases. I agree to the photo submission release policy.Photo Release Consent (Photos taken of you)(Required)I hereby consent to be interviewed, recorded, photographed, videotaped or filmed by representatives of Quivira Coalition. Quivira, and others with Quivira’s consent, have non-exclusive rights to use and publish the photographs, quotes, audio, and video for all legitimate purposes, such as (but not limited to) educational, advertising, fundraising, display or in conference materials. I also consent to the use of my name in connection with such photographs or videos. I agree that such interviews, recordings, articles, quotes, photographs, films, audio or video, are the property of Quivira, and I relinquish any present or future claim for reimbursement for said photographic or film reproduction of my likeness or for said testimonials by me. I acknowledge that I have read this consent form in its entirety, or it has been read (or translated) to me, and I have had the opportunity to ask questions about it and understand it. I agree to the photo release policy.SignatureCommentsThis field is for validation purposes and should be left unchanged. Δ