The Rodale Institute's Kidsregen.org
2007 Organic School Garden Awards
Standard Model Release Form

I hereby consent that the photograph(s) of myself and/or my child and/or my property may be used, displayed, or sold by The Rodale Institute ___with [or] ___ without my name, for editorial, marketing, or advertising purposes, either in printed or electronic (website) form, without any restrictions.**

(Please check one.)

___I am of full age

___I act as the parent/guardian of the minor

Parent/guardian's name
(please print)
Street address
City, state, zip
Parent/guardian's signature
Child's name
School's name
Classroom #
Teacher's name
**All entry material becomes the property of The Rodale Institute and Kidsregen.org. By submitting the same you acknowledge and agree that The Rodale Institute and kidsregen.org may reproduce the same and all materials may be displayed (in part or in whole) at The Rodale Institute and Kidsregen.org's discretion in printed or digital format. Such presentation material will not be returned to you. Finally, you acknowledge and agree that should your school be selected as a winner under this competition, then to the extent any of the photographs or materials submitted contain the names or likeness of students, teachers and/or others, you will be required to have the adult individuals (and the parents/guardians of such students) sign Release forms provided by us so that we can display those photographs or materials concerning your winning garden. Such requirement would be a condition of your accepting the award.

The Rodale Institute is a 501(c)(3) nonprofit organization located in Kutztown, PA. The Rodale Institute works with people worldwide to achieve a regenerative food system that renews environmental and human health. Kidsregen.org is an educational program of The Rodale Institute.

 

Remember — No Signed Release Form — No Picture!