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Photo/Video Release Form (Individual)

I hereby grant permission, without reservation, to the United Jewish Appeal-Federation of Jewish Philanthropies of New York, Inc. (“UJA-Federation”), and those authorized by UJA-Federation, to take photographs and to make recordings of me, and to use them in original or modified form in all media now or hereafter known, with or without my name or information about me, for the promotion, public education, and/or fundraising activities of UJA-Federation. I understand and agree that I am entitled to receive no compensation for the above.

I hold harmless and release and forever discharge UJA-Federation, its officers, directors, agents, employees, independent contractors, licensees, and assignees from all claims, demands, and causes of action that I, my heirs, representatives, executors, administrators, or other persons acting on my behalf or on behalf of my estate now have or in the future may have, relating to the above.

I agree that UJA-Federation will be the sole owner of all tangible and intangible rights in the abovementioned photographs and recordings, with full power of disposition.

I am over 18 years of age.