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Self-portrait workshop with Kira Nam Greene

01/06/2024 10:30 AM - 02:00 PM CT

First Name: Last Name: Email: Day Phone: Address: City: State: Zip: - Number of Attendees:

Include myself as an attendee:

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Waiver Statement:

The Montgomery Museum of Fine Arts (“MMFA”) loves to include images of visitors in our many publications and advertisements. If you are willing to let us record you and/or your child and use these recordings in our materials, please acknowledge below:

Event/Program:

In consideration for my child being allowed by the MMFA to participate in the event/program identified above, I grant the MMFA the right to:

record my and/or my child’s image and/or voice on digital or film photography, video tape, audio tape, or any other medium;
use such recordings with or without my and/or my child’s name for publicity, advertising, documentation, education, or any other purpose deemed appropriate by the MMFA; and
use, copyright, reproduce, display, distribute, and publish such recordings, altered or unaltered, in print, electronic, or any other medium.

I have read and understand the above and have the authority to grant these rights.

Yes, I agree

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