Leadership Susquehanna Valley

Photo Waiver Form

Photo Use Release Form

Leadership Susquehanna Valley has the right to take, edit, alter, copy, exhibit, publish, distribute, and make use of any and all pictures or video taken of me to be used in an/or for legally promotional materials, including, but not limited to newsletters, flyers, posters, brochures, advertisements, fundraising letters, press releases, websites, social networking sites, and other print/digital communications without payment or any other consideration. This authorization shall continue indefinitely, unless I otherwise revoke said authorization in writing.

I understand and agree that these materials shall become the property of Leadership Susquehanna Valley.

Name *