FOCUS MID-SOUTH AND FOCUSMIDSOUTH.COM
LGBT PUBLICATION AND WEBSITE
MODEL RELEASE | YOUTH RELEASE | PARENT CONSENT TO PUBLISH
I hereby grant Focus Mid-South magazine and focusmidsouth.com (an LGBT-centric magazine and website) permission to use any or all information obtained during the interview, and in subsequent contacts, related to _____________________, a minor. I also grant Focus Mid-South magazine and focusmidsouth.com permission to use any photograph or likeness of me taken by Focus Mid-South magazine and focusmidsouth.com photographers.
I understand that information from my interview and any photos may be used in a story to be published in Focus Mid-South magazine and online at focusmidsouth.com (an LGBT-centric magazine and website). I understand Focus Mid-South magazine and focusmidsouth.com is distributed in print in the Mid-South, by mail subscription, and online/worldwide on the internet which can be read by anyone in the world with access to the Internet, and may be available for years to come. I have been advised by Focus Mid-South magazine and focusmidsouth.com that, as a minor, I will discuss my decision to consent to such publication with my parents or legal guardians. My parents and I are providing permission to Focus Mid-South magazine and focusmidsouth.com to use my information and photographs of my own free will because I believe others may benefit from knowing of my experiences.
Specifically, my permission includes the following:
1. The right to publish and republish, at any time, the above information or photos in Focus Mid-South magazine and focusmidsouth.com web site and in any subsequent medium for any noncommercial purpose, including promotion of Focus Mid-South magazine and focusmidsouth.com;
2. The right of Focus Mid-South magazine and focusmidsouth.com or individual authors or photographers to copyright such information or photographs in their own name;
3. The right of Focus Mid-South magazine and focusmidsouth.com to use my name in connection with such information or photos if it chooses.
I waive any right to inspect or approve the finished story or stories, photographs or other uses of my information that may be published.
In consideration of my participation, I understand that, at my request, Focus Mid-South magazine and focusmidsouth.com will, upon request, provide me (by USPS) with up to two copies of any issue that contains information or photographs related to me at no charge. I understand that the magazine is also distributed in many locations in the area for free and that I may take copies from stands.
I hereby release and discharge Focus Mid-South magazine and focusmidsouth.com, its staff members, Ray Rico Freelance and its employees from any claims and demands arising out of or in connection with the use of the information or photographs described above, including any claims for libel or invasion of privacy.