Form Center

2. Liberty Township's 2021 Photography Contest Image Release

4. I, the undersigned, hereby authorize Liberty Township, Delaware County to utilize photographs of myself and/or the child/ward listed below to be used by Liberty Township-Delaware County, its' parks programs, events, services and facilities for any lawful purpose. I understand that the images may be used at their sole discretion at any time. By signing this release, I understand and agree that I will not be compensated for the use of the aforementioned materials. Please submit one Release for each model.

   I understand that my participation (or the participation of the child/ward I am authorized to sign for) is voluntary.

6. Name of Photographer:*
8. Title of Entry/Photograph:*
10. Name of "Model(s)":*
12. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
14. Electronic Signature
16. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
18. Electronic Signature of Parent/Guardian (if model is under 18 years of age):
20. Date:*
    Date:
Leave This Blank:


22. 1. Receive an email copy of this form.
23. Email address

    This field is not part of the form submission.

24. Submit

* indicates a required field