Media Release Form Name(Required) First Last Email(Required) Date(Required) MM slash DD slash YYYY Consent(Required) I agree to the media release.I grant permission to G.P. Reeves Inc. to use my image (photographs, audio, and/or video) for use in any associated digital video, photo, and print publications. I hereby waive any right to inspect or approve the finished images or content that may be used in conjunction with them now or in the future, whether that use is known to me or unknown, and I waive any right to royalties or other compensation arising from or related to the use of the image. I acknowledge that I have read this release before signing, and I fully understand the contents, meaning and impact of this release. Additionally my signature below designates my agreement to these terms for myself, and/or anyone/anything at my facility.Digital Signature(Required)Type your full name to agree to the terms above.